Hepatic cyst

What are liver cysts?

Liver cyst is a term that refers to small fluid-filled cavities, which form in or around the liver. Dysontogenetic liver cysts are due to an intrauterine developmental disorder arise from dilated biliary tracts and can grow with progression of the disease.

Causes of liver cysts

Mainly liver cysts manifest due to ADPKD (autosomal dominant polycystic kidney disease), a genetic disorder in which cysts primarily develop in the kidneys. These are accompanied by liver cysts. Echinococcus granulosus, an infectious tapeworm, may also be the cause of liver cysts with its larvae being transmitted to humans by dogs.

The symptoms: How does it feel to have a liver cyst?

Physical symptoms depend on number and size of the liver cysts. While smaller cysts may often remain unnoticed, they can compress surrounding organs as they grow in size and number. Patients mostly complain about a feeling of pressure and full belly as well as limited and painful daily activities such as bending over or sitting. Later on, nausea, back pain and growing abdominal girth can join the symptoms.

Also smaller cysts that show no symptoms may cause severe abdominal pain, which is caused by bleeding into the cyst or its rupture.

Generally, the bigger the cyst, the higher the probability of the cyst causing a complication.

Diagnosis: How are liver cysts detected?

Ultrasound is the most frequently used diagnostic tool. It is widely available and very suitable to watch closely how a cyst progresses, as early recognition is essential once it becomes a problem. For more detailed evaluation, diagnostic modalities such as CT or MRI can be useful.

Treatment and surgery

As a general rule, only those patients who are restricted by liver cysts and experience symptoms are eligible for treatment. Goal of treatment is remission of all symptoms and prophylaxis of reappearance of these complaints.

Partial resection of the liver is an option. It involves surgical removal of the cystic parts of the liver to relieve the patient. However, partial liver resections can only be carried out in patients whose liver still has enough healthy tissue. Another treatment option is cyst fenestration, during which the cysts are opened laparoscopically. This minimally invasive method only requires very small skin incisions and multiple cysts can be eliminated in one sitting. Liver transplantation is the final solution, also called ultima ratio. It represents the only way of cure. Also conservative treatment is possible in which patients are put on a medication regimen with somatostatin analogs. These drugs lead to a decreased fluid production in the cysts, even though it is a costly option for long-term treatment.

What should be considered in case of liver cysts?

All in all, liver cysts are a benign condition. There is no increased risk for these cysts to transform into a tumor. The liver can manage all bodily functions despite being infiltrated by cysts and is not restricted by them. The major issue that requires attention is the possibility of expansion of the liver which may lead to mentioned complications.

Which doctors and clinics are specialists for diagnosis and therapy of liver cysts?

General or visceral surgery is the medical field that specializes on liver diseases such as liver cysts. Furthermore, gastroenterologists can make the diagnosis, as they focus on the gastrointestinal tract.