Congenital solitary cysts of the liver and spleen

Abstract

Three symptomatic cases of congenital solitary cyst are reported, one in the liver and two in the spleen. Recurrence of the hepatic cyst after partial excision and drainage was complicated by fistula formation between the cyst and the duodenum. The fistula was successfully closed at a second operation. Calcification of the cyst wall occurred in one of two epithelial cysts of the spleen in young women, which were treated by splenectomy. Besides their rarity, congenital solitary cysts of the liver and spleen have several other features in common. Isotopic and ultrasonic scanning assist diagnosis in both conditions.

The management of large congenital liver cysts

“…Although hydatid disease predominates world-wide, in developed countries where Taenia echinococcus is uncommon, cysts are as likely to be congenital in origin (Williamson et al, 1978). Non-parasitic cysts are either neoplastic, traumatic or congenital.…”

“…A fistula between the cyst and the first part of the duodenum was delineated on barium meal examination and successfully closed at a second operation. The case is reported in greater detail elsewhere (Williamson et al, 1978). …”

“…The location, extent and precise anatomical relationships of the cyst should be determined, and operative cystography or cholangio-graphy may be helpful (Jones et al, 1974). Complete excision by enucleation or by partial hepatic resection is the treatment of choice, whenever feasible (Ameriks, Appleman and Frey, 1972;Russell, 1972;Williamson et aL, 1978). Emptying the cyst contents by needle aspiration assists hepatic mobilization, but thoracolaparotomy was needed to ensure adequate access in Case 3.…”

“…Some 500 cases have been reported since Brodie described hepatic cyst in 1846 (Jones, Mountain and Warren, 1974;San Felippo, Beahrs and Weiland, 1974;Williamson, Ramus and Shorey, 1978). Polycystic disease may affect the liver with or without renal involvement (Jones et al, 1974), but solitary hepatic cysts seem to be about as common (Henson, Grey and Dockerty, 1956).…”