Journal of Nippon Medical School: Vol.70 No.6 page.515

Journal of Nippon Medical School

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ArticleTitle Infected Solitary Hepatic Cyst

AuthorList Hiroshi Yoshida¹, Takashi Tajiri¹, Yasuhiro Mamada¹, Nobuhiko Taniai¹, Youichi Kawano¹, Yoshiaki Mizuguchi¹, Tetsuya Shimizu¹, Tsubasa Takahashi¹, Eiji Uchida¹, Manabu Watanabe² and Eiichi Uchida²

Affiliation ¹First Department of Surgery, Nippon Medical School
²Uchida Hospital

Language EN

Volume 70

Issue 6

Year 2003

Page 515-518

Received January 9, 2003

Accepted April 7, 2003

Keywords infection, hepatic cyst, percutaneous transhepatic drainage

Abstract An unusual case involving an infected hepatic cyst in which the correct diagnosis was made without operation is reported. A 93-year-old woman presented with acute onset of right upper quadrant abdominal pain, mild left lower quadrant abdominal pain, diarrhea, and fever. On admission, computed tomography revealed a 15 cm solitary hepatic cyst in the anterior-superior segment of the liver with a thickened wall that enhanced with contrast media. Ultrasonography demonstrated a 15 cm anechoic lesion with a hypoechoic area in the dependent portion of the cyst and a thickened wall. The serum concentration of C-reactive protein was 24.3 mg/dL, and the white blood cell count was 13,800/μL. A diagnosis of infected hepatic cyst was suspected, and percutaneous transhepatic drainage of the cyst was performed. Milky yellow fluid was obtained and the patient's right upper quadrant abdominal pain resolved after drainage. Klebsiella pneumoniae was cultured from the drainage fluid. The patient was discharged 20 days after drainage. Infection has not recurred and the hepatic cyst has not enlarged after 18 months.

Correspondence to Hiroshi Yoshida, MD, First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
hiroshiy@nms.ac.jp

ArticleTitle	Infected Solitary Hepatic Cyst
AuthorList	Hiroshi Yoshida¹, Takashi Tajiri¹, Yasuhiro Mamada¹, Nobuhiko Taniai¹, Youichi Kawano¹, Yoshiaki Mizuguchi¹, Tetsuya Shimizu¹, Tsubasa Takahashi¹, Eiji Uchida¹, Manabu Watanabe² and Eiichi Uchida²
Affiliation	¹First Department of Surgery, Nippon Medical School ²Uchida Hospital
Language	EN
Volume	70
Issue	6
Year	2003
Page	515-518
Received	January 9, 2003
Accepted	April 7, 2003
Keywords	infection, hepatic cyst, percutaneous transhepatic drainage
Abstract	An unusual case involving an infected hepatic cyst in which the correct diagnosis was made without operation is reported. A 93-year-old woman presented with acute onset of right upper quadrant abdominal pain, mild left lower quadrant abdominal pain, diarrhea, and fever. On admission, computed tomography revealed a 15 cm solitary hepatic cyst in the anterior-superior segment of the liver with a thickened wall that enhanced with contrast media. Ultrasonography demonstrated a 15 cm anechoic lesion with a hypoechoic area in the dependent portion of the cyst and a thickened wall. The serum concentration of C-reactive protein was 24.3 mg/dL, and the white blood cell count was 13,800/μL. A diagnosis of infected hepatic cyst was suspected, and percutaneous transhepatic drainage of the cyst was performed. Milky yellow fluid was obtained and the patient's right upper quadrant abdominal pain resolved after drainage. Klebsiella pneumoniae was cultured from the drainage fluid. The patient was discharged 20 days after drainage. Infection has not recurred and the hepatic cyst has not enlarged after 18 months.
Correspondence to	Hiroshi Yoshida, MD, First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan hiroshiy@nms.ac.jp