Liver cysts, medically called Hepatic cysts, are sacs containing fluid that occur on or just inside the liver. They are rarely dangerous & infect only 5 to 10% of people worldwide.
Liver cysts can be congenital (present from birth) or acquired later as an adult. They are more prevalent with age for both men & women and more predominant in women than men.
Causes and Symptoms
Simple (single) cysts are usually benign (non-cancerous), asymptomatic, and are found incidentally during ultrasound or CT scans. The size of a cyst can range from a few microns up to 4 inches.
The other rare (10 to 15%) but serious liver cyst types are:
1. Polycystic Liver Disease
Polycystic Liver Disease (PLD) is associated with polycystic kidney disease. Multiple simple cysts come together and form a cluster. It is a genetic disorder affecting 1 to 10 individuals in 1,00,000. Merely 20% of people experience symptoms & the liver can continue to function well even with the cysts.
Severe cases of PLD cause abnormal belly swelling, lack of appetite, and discomfort or pain, as the liver gets larger.
2. Hydatid cysts or Echinococcus infection
A tapeworm parasite named Echinococcus found in the faecal matter of farm animals passed onto humans through water or environmental contamination causes this type of infection. It is more common in their endemic regions.
Medical tests help identify this parasite’s presence. Its symptoms include fever, jaundice, blood in the sputum, skin itching, and high levels of white blood cells.
3. Cancerous cysts
Only up to 5% of the liver cysts become malignant (cancerous) & they might also be asymptomatic. Therefore, it is identified through biopsy.
General symptoms of liver cysts are:
· Abdomen bloating
· Dull pain in the abdomen
· Nausea
· Shortness of breath
· Feeling full eating less food
Liver cysts can cause blockage in bile ducts leading to jaundice. Rupture of the cysts produces acute pain in the abdomen.
Treatment
Depending upon their seriousness, different methods are employed to treat liver cysts. Some simple cysts may need no treatment whatsoever. Benign cysts growing larger require regular monitoring through imaging tests at 3- and 12-month intervals. No threat is associated with cysts stable for more than two years.
Some treatments usually used to treat liver cysts are as follows:
1. Medication
An antibiotic course is prescribed before further evaluation in case of infections caused due to Echinococcus parasite.
2. Minimally Invasive Procedures
Draining the fluid from cysts is achieved by performing Laparoscopy, which is minimally invasive. While this procedure is relatively simple and requires lesser recovery time, the chances of recurrence are high.
3. Deroofing/ Cyst fenestration
If the above method is ineffective, cyst wall removal called “deroofing” is done using small incisions. This procedure requires more recovery time but has a significantly low recurrence rate.
4. Cyst Excision/ Hepatectomy/ Hepatic resection
During Hepatectomy, the liver portion covered with cysts is permanently removed or extracted. It is the last resort treatment and is often not required.
5. Surgery
Transarterial embolization (TACE) is a treatment for cancerous cysts. It involves injecting anti-cancer drugs into the bloodstream connected to the liver. Cysts irresponsive to other treatments require surgical removal.
6. Liver Transplant
If all the treatment measures fail & the liver’s function starts getting affected due to the cysts, a liver transplant surgery is recommended as a worst-case scenario. Recurring cysts after treatment or cysts that bleed heavily and cause intense pain lead to this extreme case.
Liver cysts are relatively rare, asymptomatic, and identified accidentally. Hereditary conditions, travel history, medical tests, and previous occurrence of liver diseases are used to diagnose symptomatic cysts. If imaging tests reveal the presence of cysts or if any symptoms are experienced, it is wise to consult a medical practitioner or best liver hospital in chennai and get the recommended course of treatment.
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