Introduction:
Non-parasitic simple hepatic cyst is a very common type of benign liver disease, occurring in approximately 1-5% of the general population. These cysts are usually asymptomatic and are conservatively followed up without treatment. Some of these cysts, however, are associated with complications, including infection, hemorrhage, obstructive jaundice, portal hypertension, and rupture.
Presentation of case:
A 74-year-old woman was transferred to our trauma center with epigastric pain after being knocked down by a cultivator. An abdominal computed tomography (CT) scan showed fluid collection and cystic lesion around the caudate lobe of the liver. Operative exploration showed that she had a ruptured hepatic cyst that originated from the caudate lobe of the liver. The cyst was deroofed to the margins of the liver parenchyma, and the internal surfaces of the cyst walls was subjected to electrocoagulator ablation.
Discussion:
Open or laparoscopic cyst deroofing is a safe and effective treatment for non-parasitic simple hepatic cysts. Laparoscopic deroofing may also be difficult following rupture of non-parasitic simple hepatic cysts associated with infection or hemorrhage, as these cysts may collapse and the line of resection may be unclear. Laparoscopic ultrasound is a useful adjunct to delineate the boundaries of the cyst.
Conclusion:
Traumatic rupture of a non-parasitic simple hepatic cyst is a very rare complication, but can lead to acute abdomen. In patients who are known to have non-parasitic simple hepatic cyst, rupture of cyst could be included in the differential diagnosis of acute abdomen.