Liver cyst

from Wikipedia, the free encyclopedia
Classification according to ICD-10
K76.8 Liver cyst
Q44.7 Congenital liver cyst
ICD-10 online (WHO version 2019)
three liver cysts (one large, two very small) in the FDG PET / CT image (with CT contrast agent, venous phase)

A liver cyst is a fluid-filled cavity ( cyst ) embedded in the liver tissue or on top of it . Liver cysts are the benign (benign) tumors counted.

Similar to the distinction between kidney cyst (a harmless incidental finding with one cyst) and cyst kidney (a life-threatening disease with a large number of cysts), a distinction is also made in the liver between liver cyst and cyst liver . Liver cysts have a rounded shape that is sharply defined from the rest of the tissue and has a delicate wall. Liver cysts generally grow very slowly.

In the Anglo-Saxon specialist literature, the terms liver cyst or hepatic cyst or non-parasitic hepatic cyst (NPHC) are used for a liver cyst.

differentiation

In some cases, the parasitic cystic echinococcosis caused by the tripartite dog tapeworm ( Echinococcus granulosus ) is counted among the liver cysts. However, the following article only describes the non-parasitic liver cysts. For the parasitic liver cyst, see the corresponding main article .

The alveolar echinococcosis caused by the fox tapeworm ( Echinococcus multilocularis ) does not produce cysts, but microscopic vesicles ( alveoli ) enclosed by connective tissue .

Pathogenesis

The non-parasitic cysts can be inherited (congenital), traumatic (due to external influences) or neoplastic (new formation). Most often, liver cysts are hereditary. They can also form as a result of intrahepatic biliary obstruction . Liver cysts form extremely rarely as a degenerative side effect of liver cirrhosis .

etiology

Superficial liver cyst of the right lobe of the liver

Liver cysts have one or more chambers. Less often they represent a variant of a congenital cyst liver.

Prevalence

Liver cysts are very common and are usually only discovered by chance during an ultrasound , MRI or CT examination. Liver cysts are found in around 2.5 to 18% of all patients who are subjected to a general sonographic or computed tomographic examination, usually as a secondary diagnosis. The incidence is particularly high above the age of 40 .

diagnosis

Small cyst of the left lobe of the liver

Since a liver cyst is symptom-free in most cases, it is usually an incidental finding during an ultrasound examination. If symptoms or complications are present, the diagnosis is made using imaging methods , usually using ultrasound or computed tomography. A distinction can be made between non-parasitic and parasitic liver cysts.

Complications

Complications are usually caused by large cysts when they displace the surrounding organs. This is often only the case with a cyst diameter of over 10 cm. Usually this leads to pain in the upper abdomen . A rupture or hemorrhage in the cyst can cause acute pain in the abdomen .

Infection of the cyst can lead to a fever. Weight loss, nausea, and vomiting are less common complications. If the intra- or extrahepatic bile duct system is compressed too much by the space required by the cyst, jaundice can develop. Statistically speaking, these complications usually occur from the age of 50 and occur more frequently in women.

therapy

An operation is only necessary if the affected patient has symptoms caused by the liver cyst. The symptoms are almost exclusively caused by large cysts that displace the surrounding organs.

Two surgical procedures are used for therapy . The easiest way to do this is to use the CT-assisted suction (aspiration) of the cyst fluid. A subsequent injection of the sclerosant ethoxysklerol or alcohol is used to obliterate the cyst. With the simplicity of the process, the high relapse rate of up to 50% is disadvantageous.

Surgical uncovering of cysts using laparoscopic surgery , a minimally invasive procedure, is much more effective . The method was first carried out in 1991. After aspiration of the cyst fluid, the roof of the cyst is completely removed and the remaining cavity is filled with the body's own large mesh ( omentum majus ), which is sewn to the edge of the cyst. This suppresses the formation of new cysts. The recurrence rate is around 11%.

forecast

An ablated solitary liver cyst means complete healing for the affected patient .

Individual evidence

  1. ↑ charite.de: Liver cysts ( Memento of the original on 21 October 2009 at the Internet Archive ) Info: The archive link is automatically inserted and not yet tested. Please check the original and archive link according to the instructions and then remove this notice. accessed on November 1, 2008 @1@ 2Template: Webachiv / IABot / www.charite.de
  2. ↑ aerztlichepraxis.de: liver cyst  ( page no longer available , searching web archives )  Info: The link is automatically marked as defective. Please check the link according to the instructions and then remove this notice. accessed on November 2, 2008@1@ 2Template: Dead Link / www.aerztlichepraxis.de  
  3. ↑ a b c d e charite.de: Minimally Invasive Surgery: Liver Cysts ( Memento of the original from February 28, 2009 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. accessed on November 2, 2008 @1@ 2Template: Webachiv / IABot / www.charite.de
  4. ^ PA Gaines et al .: The prevalence and characterization of simple hepatic cysts by ultrasound examination. In: Br J Radiol. Vol. 62, 1989, pp. 335-337. PMID 2653548 .
  5. ↑ ZI Carrim, JT Murchison: The prevalence of simple renal cysts and hepatic detected by spiral computed tomography. In: Clin Radiol. Volume 58, 2003, pp. 626-629. PMID 12887956 .
  6. ↑ M. Caremani et al. a .: Ecographic epidemiology of non-parasitic hepatic cysts. In: J Clin Ultrasound 21, 1993, pp. 115-118. PMID 12887956
  7. ↑ L. van Keimpema et al .: Aspiration-sclerotherapy results in effective control of liver volume in patients with liver cysts. In: Dig Dis Sci. Volume 53, 2008, pp. 2251-2257. PMID 18299984 .

literature

Reference books

  • A. Hollweger: Ultrasound course. Deutscher Ärzteverlag, 2006, ISBN 3-7691-0451-X , pp. 63–70.
  • W. Wermke: Sonographic differential diagnosis of liver diseases. Deutscher Ärzteverlag, 2006, ISBN 3-7691-0433-1
  • D. Henne-Bruns among others: Surgery. Georg Thieme Verlag, 2007, ISBN 3-13-125293-6 , pp. 493-494.

Technical article

  • LL Robbins et al: Congenital cyst of liver. In: N Engl J Med . Volume 239, 1948, pp. 517-519. PMID 18885056
  • M. Rygl et al .: Congenital solitary liver cysts. In: Eur J Pediatr Surg. Volume 16, 2006, pp. 443-448. PMID 17211796
  • JF Gigot et al: The surgical management of congenital liver cysts. In: Surg Endosc . Volume 15, 2001, pp. 357-363. PMID 11395815
  • JF Gigot et al .: Laparoscopic treatment of nonparasitic liver cysts: adequate selection of patients and surgical technique. In: World Journal of Surgery . Volume 20, 1996, pp. 556-561. PMID 8661625
  • N. Katkhouda et al .: Laparoscopic management of benign cystic lesions of the liver. In: J Hepatobiliary Pancreat Surg. Volume 7, 2000, pp. 212-217. PMID 10982616 .
  • M. Morino et al .: Laparoscopic management of symptomatic nonparasitic cysts of the liver. Indications and results. In: Ann Surg . Volume 219, 1994, pp. 157-164. PMID 8129486 .
  • P. Charlesworth et al .: Natural history and long-term follow-up of antenatally detected liver cysts. In: J Pediatr Surg. Volume 42, 2007, pp. 494-499. PMID 17336186 .

Dissertations

Web links

Wiktionary: Liver cyst  - explanations of meanings, word origins, synonyms, translations