Answer
Patients with hydatid cysts, like those with simple cysts, are most often asymptomatic, but pain may develop as the cyst grows. Larger lesions typically cause pain and are more likely to develop complications than simple cysts. At presentation, patients generally have a palpable mass in the right upper quadrant.
Cyst rupture is the most serious complication of hydatid cysts. Cysts may rupture into the biliary tree, through the diaphragm into the chest, or freely into the peritoneal cavity. Rupture into the biliary tree may result in jaundice or cholangitis. Free rupture into the peritoneal cavity may cause anaphylactic shock. As with simple cysts, patients with hydatid cysts may develop secondary infection and subsequent hepatic abscesses.
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Media Gallery
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Histology demonstrating biliary epithelium lining simple cyst.
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Ultrasonographic appearance of large simple hepatic cyst.
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Computed tomography (CT) scan appearance of large hepatic cyst.
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Computed tomography (CT) scan of polycystic liver disease curiously limited to right liver.
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Hepatic cysts. Sagittal magnetic resonance imaging (MRI) reconstruction in patient with large echinococcal cyst; note daughter cysts in interior.
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Computed tomography (CT) appearance of biliary cystadenoma.
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Resection of involved liver in polycystic liver disease.
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Laparoscopic view of initial hepatic cyst puncture, before unroofing. Lesion is located high in right liver near the diaphragm.
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Laparoscopic view of beginning of unroofing of large simple hepatic cyst near dome of right liver.
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Drawing of final result of laparoscopic unroofing of a large simple hepatic cyst in right liver.
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Initial penetration of hepatic cyst with drainage of cyst fluid.
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Unroofing of hepatic cyst.
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Omentum sutured to excised margin.
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