Cholangitis complicated by infection of a simple hepatic cyst
An 87-year-old man was admitted to our hospital due to fever and elevated liver enzymes. Computed tomography (CT) scan revealed bile duct stones with a dilated biliary system, which confirmed the diagnosis of cholangitis. A 12-cm simple hepatic cyst was also seen in the right liver, which had been detected on CT scan 5 years before, and did not change in size. Fever did not subside even after endoscopic biliary drainage and a repeated CT scan showed an enlarged cyst up to 14 cm, suggesting cyst infection. An enlarged hepatic cyst collapsed after percutaneous transhepatic drainage, along with resolution of fever. Simple hepatic cysts are common and most of them are asymptomatic. Infection of simple hepatic cysts is a rare condition and the major entry route is considered as the biliary tract as communication between the biliary tract and cysts is reportedly observed in those cases. However, in our case, no communication was seen on cholangiogram or cystogram on fluoroscopy and bilirubin level of the cyst aspirate was low. Given the fact that patients with cholangitis are rarely complicated by hepatic cyst infection, other routes of bacterial entry to simple hepatic cysts should also be considered.
KeywordsInfected hepatic cyst Cholangitis Nonparasitic hepatic cyst
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
In this case report, the patient’s consent was obtained through an out–out methodology.
- 5.Hara T, Nagasaki Y, Nakata H, et al. Cryptogenic liver abscess associated with liver cyst. Wakayama Med Rp. 1984;27:133–40.Google Scholar
- 8.Sato H, Tsukahara M, Okada M. A difficult clinical case of infected liver cyst. Nihon Geka Kansensho Gakkai Zasshi. 2009;6:649–53.Google Scholar
- 9.Ito Y, Irino T, Egawa T, et al. A case of an infected liver cyst associated with cholangitis and cholecystitis. Nihon Fukubu Kyukyu Igakukai Zasshi. 2012;32:101–4.Google Scholar
- 13.Fukamachi S, Nakagawa K, Tsukidate H, et al. A case of infected liver cyst following laparoscopic cholecystectomy. Sendai Sekijuji Byoin Igaku Zasshi. 2012;l 21:33–7.Google Scholar
- 14.Kataoka M, Yoshioka S, Wakatsuki K, et al. A case of hepatic cyst infection which occurred in perioperative period after abdominal surgery. Rinsho Geka. 2012;67:833–6.Google Scholar