-Case Reports-

Intracystic Hemorrhage Required No Treatment from One of Multiple Hepatic Cysts

Youichi Kawano^1,2, Hiroshi Yoshida³, Yasuhiro Mamada^1,2, Nobuhiko Taniai^1,2, Sho Mineta^1,2, Masato Yoshioka^1,2, Yoshiaki Mizuguchi^1,2, Yasumi Katsuta⁴, Chiaki Kawamoto⁴ and Eiji Uchida^1,2

¹Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
²Department of Surgery, Nippon Medical School
³Department of Surgery, Nippon Medical School Tama Nagayama Hospital
⁴Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School

We describe a patient with intracystic hemorrhage from one of multiple hepatic cysts. A 66-year-old woman was admitted to Nippon Medical School Hospital because of pain in the right upper quadrant of the abdomen. The medical history included multiple hepatic cysts and angina pectoris, which had been treated with aspirin. Three weeks before presentation, pain occurred in the right upper quadrant of the abdomen but resolved spontaneously. Ultrasonography revealed multiple hepatic cysts. One of the cysts in segment 8 had a hypoechoic structure and contained fluid. Computed tomography showed an area of homogenous density (diameter, 6 cm) which was slightly greater than that of the other hepatic cysts in segment 8. There was calcification of the cyst wall. On magnetic resonance imaging, this cyst showed heterogeneous hyperintensity on T1- and T2- weighted sequences which was greater than that of the other hepatic cysts. Intracystic hemorrhage of one of the multiple hepatic cysts was diagnosed. The pain gradually resolved without drainage, embolization, or operation, and the patient was discharged. After discharge, the upper abdominal pain did not recur. On magnetic resonance imaging 14 months later, the cyst showed heterogeneous hyperintensity on T1- and T2- weighted sequences which was less than that on the previous scan.

J Nippon Med Sch 2011; 78: 312-316

Keywords
intracystic hemorrhage, hepatic cyst, multiple, liver

Correspondence to
Youichi Kawano, MD, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
y-kawano@nms.ac.jp

Received, February 23, 2011
Accepted, May 6, 2011