PMC5577080_01
An ultrasound scan reveals a giant hepatic cyst. Echogenic substances are visible at the bottom of the cyst leading to a "fluid-fluid" level.
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Abdominal ultrasonography revealed a 67x49x47 mm giant hepatic cyst filled with multiple hyperechoic spots (Fig. 1).
A computed tomography scan showing a giant hepatic cyst in the right lobe of the liver compressing the adjacent diaphragm, right ventricle and the inferior vena cava (arrow heads).
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A contrast computed tomography (CT) scan of the chest and abdomen showed a giant hepatic cyst in the right lobe of the liver elevating the right hemidiaphragm while at the same time compressing the right atrium and the IVC (Fig. 2).
Angiography imaging and flow studies of the inferior vena cava (IVC) before the drainage procedure. The IVC pressure was 23 mmH2O, and the vessel was compressed and curved by the liver cyst (arrow heads). The bilateral pulmonary arteries were easily visible. The oxygen saturation was <70% on 35 L/min high O2 flow.
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Following hospital admission, angiography demonstrated severe tapering of the segmental pulmonary arteries in both lungs without any intracardiac or intrapulmonary shunts (Fig. 3).
Angiography imaging and flow studies of the inferior vena cava (IVC) after the drainage procedure. The IVC pressure was 13 mmH2O, and the IVC drained directly into the right atrium (arrow heads). The pulmonary artery outflow tract and bilateral pulmonary arteries were clearly visible (white arrow). The oxygen saturation levels improved to more than 90% breathing ambient room air.
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Angiography that was repeated after the drainage procedure showed a reduction in the calibre of the IVC stenosis (Fig. 4).