Polycystic liver disease with obstructive jaundice: Treatment with ultrasound-guided cyst aspiration

Abstract

A 59-year-old woman with polycystic liver (PCLD) and kidney disease (PCKD) presented with jaundice, fever, and abdominal pain. A computered tomographic (CT) scan performed immediately after an endoscopic retrograde cholangiopancreatogram (ERCP) clearly demonstrated a hepatic cyst obstructing the biliary system. The cyst was then aspirated under ultrasound guidance with complete relief of obstruction.

Experience with different methods of treatment of nonparasitic liver cysts

“…This is used mainly to mitigate acute complaints, as the rate of complications is high, and there is a high probability of recurrence of the cysts [3,6,9,10,11,12,13]. A number of authors suggest the sclerotization of liver cysts with ethoxysclerol or with absolute alcohol, while others report favorable experience with drainage [14,15,16] However, El Mouaaouy et al [15] observed a 6% rate of complications, including very grave ones. No complications were seen in our patients following puncture and sclerotizing treatment, but the high rate of recurrence does not indicate any advantage of this procedure.…”

Volume Progression and Imaging Classification of Polycystic Liver in Early Autosomal Dominant Polycystic Kidney Disease

“…Body mass index, genotype, and baseline height-adjusted total kidney volume were not associated with the growth rate of height-adjusted liver cystic volume or height-adjusted liver volume. According to the height-adjusted liver cystic volume growth rate, patients were classified into five classes (number of women, men in each class): A (24, six); B (44, 13); C (43, 48); D (28,17); and E (13, nine).…”

“…Third, although the Mayo imaging classification model was found to be a strong predictor of subsequent eGFR decrease, our proposed polycystic liver disease imaging classification lacks proven clinical correlations. However, massive polycystic livers are a significant clinical problem for many patients due to pain and mass effects (1 –7,9,11,12,15,16,28 –33). Further, a previous cross-sectional study of HALT PKD demonstrated a positive correlation between increases in htLV and reductions in quality of life (14).…”

“…Body mass index, genotype, and baseline height-adjusted total kidney volume were not associated with the growth rate of height-adjusted liver cystic volume or height-adjusted liver volume. According to the height-adjusted liver cystic volume growth rate, patients were classified into five classes (number of women, men in each class): A (24, six); B (44, 13); C (43, 48); D (28,17); and E (13, nine).Conclusions Compared with height-adjusted liver volume, the use of height-adjusted liver cystic volume showed greater separations in volumetric progression of polycystic liver disease. Similar to the Mayo imaging classification for the kidney, the progression of polycystic liver disease may be categorized on the basis of patient's age and height-adjusted liver cystic volume.…”

Polycystic Liver Disease: Pathophysiology, Diagnosis and Treatment

“…Thus, compression of the biliary tree may be associated with the development of jaundice in these patients. 124,[128][129][130] Liver failure is rarely observed and usually associated with a very advanced disease stage. 110,116 PLD can develop in both sexes, but women usually have a more severe hepatic phenotype, especially those with a history of multiple pregnancies and prolonged exposure to exogenous estrogen.…”