Journals / Turkish journal of emergency medicine (Online) / 2020 / Cilt: 20 - Sayı: 2

Cardiac compression of a hepatic cyst in polycystic liver disease: A rare cause of hemodynamic instability

Pages
93–96
Publication Date
2022-11-05
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Hepatic cysts in patients with PLD may compress adjacent structures, and cardiac compression can be life-threatening if hemodynamic instability occurs.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Polycystic liver disease (PLD) develops due to embryonic ductal plate malformation of intrahepatic bile ducts.
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Key Findings & Data:A 71-year-old female patient was admitted to our emergency department with increasing dyspnea, chest pain, and abdominal distension.
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Conclusion & Impact:Hepatic cysts in patients with PLD may compress adjacent structures, and cardiac compression can be life-threatening if hemodynamic instability occurs.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Polycystic liver disease (PLD) develops due to embryonic ductal plate malformation of intrahepatic bile ducts. Cysts in the liver can range from a simple compression effect to severe liver failure. The most common complication is rupture and inflammation of cyst. It can sometimes progress to the extent of pushing the heart to the left or compressing the inferior vena cava, thereby reducing the venous return. Here, we present a case with giant liver cyst-related symptoms that caused external compression of the right ventricle and atrium. A 71-year-old female patient was admitted to our emergency department with increasing dyspnea, chest pain, and abdominal distension. Her vital signs were as follows: temperature 38°C, pulse 140 beats/min, and blood pressure 70/40 mmHg. Her abdomen was distended, and there was minimal epigastric tenderness. Hepatomegaly was also present. Posteroanterior chest radiography revealed opacity that erased the right diaphragm contour at the right inferior hemithorax. In thoracoabdominal computed tomography, the heart was deviated toward the left due to the compression of a large cystic formation located in the hepatic right lobe, pushing the diaphragm to the superior. Piperacillin/tazobactam 3 g × 4.5 g treatment was initiated, and external drainage was performed by interventional radiology. Following this procedure, significant improvement was observed in the patient’s condition. Her symptoms significantly improved, and the drainage catheter was removed on the seventh day. Hepatic cysts in patients with PLD may compress adjacent structures, and cardiac compression can be life-threatening if hemodynamic instability occurs.

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Cite This Article

Özdemir, S., Erdoğan, M. Ö., Algın, A., Inan, I., Sarıaydın, M. (2022). Cardiac compression of a hepatic cyst in polycystic liver disease: A rare cause of hemodynamic instability. Turkish journal of emergency medicine (Online), Cilt: 20 - Sayı: 2, 93–96. https://ajindex.com/articles/605243

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References (11)

  1. Bae KT, Zhu F, Chapman AB, Torres VE, Grantham JJ, Guay‑Woodford LM, et al. Magnetic resonance imaging evaluation of hepatic cysts in early autosomal‑dominant polycystic kidney disease: The consortium for radiologic imaging studies of polycystic kidney disease cohort. Clin J Am Soc Nephrol 2006;1:64‑9
  2. Genetics2 Wills ES, Cnossen WR, Veltman JA, Woestenenk R, Steehouwer M, Salomon J, et al. Chromosomal abnormalities in hepatic cysts point to novel polycystic liver disease genes. Eur J Hum Genet 2016;24:1707‑14
  3. Gevers TJ, Drenth JP. Diagnosis and management of polycystic liver disease. Nat Rev Gastroenterol Hepatol 2013;10:101‑8
  4. Kwok MK, Lewin KJ. Massive hepatomegaly in adult polycystic liver disease. Am J Surg Pathol 1988;12:321‑4
  5. Carrim ZI, Murchison JT. The prevalence of simple renal and hepatic cysts detected by spiral computed tomography. Clin Radiol 2003;58:626‑9
  6. Macutkiewicz C, Plastow R, Chrispijn M, Filobbos R, Ammori BA, Sherlock DJ, et al. Complications arising in simple and polycystic liver cysts. World J Hepatol 2012;4:406‑11
  7. Ker J. The liver and right atrium‑hepatic cyst as a cause of arrhythmia. Clin Med Insights Cardiol 2010;4:63‑7
  8. Ghatak T, Azim A, Sharma A, Mahindra S. Post‑operative refractory hypotension due to right heart compression by hepatic cysts in a patient with autosomal dominant polycystic kidney disease. J Anaesthesiol Clin Pharmacol 2013;29:572‑4
  9. Li Vecchi M, Buscemi S, Nardi E, Azzolina V, Provenzano R. A case of cardiac compression by hepatic cyst in a woman with polycystic kidney disease. Intern Emerg Med 2008;3:69‑71
  10. Spârchez Z, Radu P, Zaharie F, Al Hajjar N, Sparchez M. Percutaneous treatment of symptomatic non‑parasitic hepatic cysts. Initial experience with single‑session sclerotherapy with polidocanol. Med Ultrason 2014;16:222‑8
  11. Vardakostas D, Damaskos C, Garmpis N, Antoniou EA, Kontzoglou K, Kouraklis G, et al. Minimally invasive management of hepatic cysts: Indications and complications. Eur Rev Med Pharmacol Sci 2018;22:1387‑96.