Infected Hepatic Cyst Treated with Percutaneous Transhepatic Drainage

Ishii, Kensuke; Yoshida, Hiroshi; Taniai, Nobuhiko; Moneta, Sho; Kawano, Youichi; Tajiri, Takashi

doi:10.1272/jnms.76.160

Cited by 20 publications

(17 citation statements)

References 25 publications

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“…No patient had a hemorrhagic and numbers of hepatic cysts [6][7][8] . Documented complications of nonparasitic hepatic cystsinclude obstructive jaundice [9,10] , rupture [11][12][13] , intracystic hemorrhage [13][14][15][16] , and infection [17][18][19] . In PLD, the polycystic liver annually grows by 0.9% to 3.2% [20][21][22][23][24] .…”

Section: Resultsmentioning

confidence: 99%

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Yoshida

Makino

Yokoyama

et al. 2016

Journal of Gastroenterology and Hepatology Research

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AIM:The present study evaluated the safety and effectiveness of repeated injections of minocycline hydrochloride (MINO) for symptomatic polycystic liver disease (PLD). METHODS:We retrospectively studied patients who received percutaneous MINO injections for symptomatic PLD and were followed up for at least 2 years between 2002 and 2015. Huge hepatic cysts (diameter > 10 cm) were treated by continuous drainage and multiple MINO injections. Small hepatic cysts underwent one-step drainage followed by a single injection of MINO. Only several cysts that caused complications were treated by percutaneous injection of MINO. Patients were discharged 1 day after treatment. RESULTS: Ten patients, (4men and 6 women; mean age, 57.8 years) were studied. All patients had Type 2 PLD according to Gigot's classification. The chief complaints were abdominal distension (n = 10), abdominal pain (n = 6), back pain (n = 4), and appetite loss (n = 8). Four patients had mild liver dysfunction. One patient complained of moderate right subscapular pain immediately after the injection, and another had pain at the site of catheter insertion. Liver dysfunction did not develop in any patient after treatment. The mean follow-up was 63.4 months. The interval from the first to last admission for MINO injection therapy was 14 to 148 months (mean, 40.8 months). The number of admissions for MINO injection therapy ranged from 2 to 12 times (mean, 4.0 times). The average interval for MINO injection therapy was 8.3 to 19 months (mean, 14.8 months).The hepatic cysts shrank in all patients after treatment. Complications improved consistently, and all patients were satisfied with the outcome of treatment. CONCLUSIONS: Symptomatic PLD was controllable by 14.8 months of repeated MINO injections on average. Repeated MINO injections are a safe, definitive treatment for symptomatic PLD.

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Section: Resultsmentioning

confidence: 99%

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Yoshida

Makino

Yokoyama

et al. 2016

Journal of Gastroenterology and Hepatology Research

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“…The primary indications for aspiration sclerotherapy of liver cysts are the size of the lesions and the patient's symptoms. Ishii et al (2) recommended the use of percutaneous transhepatic drainage under ultrasonographic guidance with the injection of sclerosing agents, which are thought to kill the secretory cells of hepatic cysts and decrease the size of the lesion. The most commonly used sclerosing agent is ethanol; however, minocycline and tetracycline are also sometimes administered.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 4,680 mL of purulent fluid was drained, which indicated infection of the hepatic cyst. Five repetitions of conglutination with minocycline (MINO) were performed (2). No pathogens were isolated from the drainage fluid.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Cyst Infection in an Autosomal Dominant Polycystic Kidney Disease Patient Diagnosed by Right Pleural Effusion

et al. 2014

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A 64-year-old Japanese man with renal dysfunction caused by autosomal dominant polycystic kidney disease (ADPKD) was admitted to our hospital for evaluation of right back pain, fever, inflammation, and pleural effusion. Diagnostic investigations for tuberculous pleuritis were all negative. Although no radiographic abnormality suggesting hepatic cyst infection was detected by computed tomography, hepatic cyst drainage demonstrated purulent contents indicative of cyst infection. Conglutination of the cyst by minocycline 100 mg was performed five times in addition to drainage. After drainage, the symptoms of inflammation, right back pain and right pleural effusion subsided. Renal function and anemia, which had been resistant to darbepoetin treatment, also improved after the procedure. These results suggested that the infected hepatic cyst was associated with the patient's symptoms, exacerbation of renal dysfunction and anemia. The pleural effusion was due to the propagation of inflammation from the cyst infection. This is the first report of an infected hepatic cyst in an ADPKD patient presenting with and diagnosed by right pleural effusion.

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“…Most liver cysts are present as thin-walled bubbles in the liver and usually do not produce any signs or symptoms; such cysts are commonly diagnosed incidentally on ultrasound or computed tomography (CT) examinations. In cases of serious complications of non-parasitic liver cysts, the cysts sometimes rupture spontaneously, with (3) or without (4) hemorrhage, or become infected (3,5), often inducing pain; therefore, special treatment must be considered (2). Direct perforation of a liver cyst into the upper gastrointestinal tract is a very unusual event that requires emergency surgery (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Perforation of a Duodenal Ulcer into a Non-Parasitic Liver Cyst: A Rare Case of a Penetrate Hole Blockaded with Conservative Medical Management

Ono¹,

Takeda²,

Makihata³

et al. 2014

Intern. Med.

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An 88-year-old Japanese woman was admitted to our hospital for abdominal pain with a raised inflammatory reaction. Esophagogastroduodenoscopy (EGD) and computed tomography (CT) showed a duodenal ulcer punching a liver cyst. Since neither ascites nor free air were detected on CT and her family did not wish for aggressive medical treatment, the patient received clinical observation and conservative management. Antibiotic and proton-pump inhibitor therapy was effective, and she exhibited an uneventful recovery. A reexamination of EGD and CT confirmed that the fistulous tract between the liver cyst and duodenum was blockaded.

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Infected Hepatic Cyst Treated with Percutaneous Transhepatic Drainage

Cited by 20 publications

References 25 publications

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Hepatic Cyst Infection in an Autosomal Dominant Polycystic Kidney Disease Patient Diagnosed by Right Pleural Effusion

Perforation of a Duodenal Ulcer into a Non-Parasitic Liver Cyst: A Rare Case of a Penetrate Hole Blockaded with Conservative Medical Management

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