Liver Cyst

Question 1

Define liver cyst

Answer 1

Fluid filled sacs in the liver

Question 2

What are the causes/risk factors of liver cysts?

Answer 2

Simple cysts
• Unknown cause (possibly congenital)

Hydatid cysts
• Echinococcus granulosus (tapeworm)
• Infection may occur from contact with contaminated dog faeces

• Polycystic liver disease
• Neoplastic cysts

Question 3

What are the symptoms of liver cysts?

Answer 3

• Dull RUQ pain

Question 4

What are the signs of liver cysts?

Answer 4

• Palpable mass in RUQ

Question 5

What investigations are carried out for liver cysts?

Answer 5

• FBC - anaemia, leucocytosis, eosinophilia in hydatid cysts
• LFTs - raised ALP, BR
• ESR/ CRP - elevated
• Blood Cultures - positive for the causative bacteria in pyogenic abscesses.
• Serology - antibodies positive for amoeba and hydatid.
• Stool Cultures - positive for E. histolytica and tapeworm eggs.
• USS - localises the cyst
• CT/ MRI - localises the cyst
• CXRAY - look for right pleural effusiom, atelectasis, raised hemidiaphragm
• Aspiration and abscess culture - most pyogenic liver abscesses are polymicrobial. Amoebic abscesses contain ‘anchovy sauce’ fluid of necrotic hepatocytes and trophozoites