Liver cysts or hepatic cysts are round, thin sac-like structures found scattered in the tissues of liver. Sizes of liver cysts vary, ranging from 2 mm to more than 20 cm in diameter. However, most people have cysts of about 2 cm size. Surrounded by hepatic tissues, they are either empty or contain semi-fluid substances. As per medical data, hepatic cysts are more common amongst males and senior citizens. But, the chances of developing symptomatic cysts are higher in female patients.
Causes and Symptoms
Most cases of cysts on liver are idiopathic, i.e. there are no significant reasons for their formation. They are known to develop as a result of congenital (present at birth) aberrations of the bile duct. Few cases of liver cysts are caused due to other severe complications such as polycystic liver disease (massive enlargement of liver), liver cancer, Caroli's disease, congenital hepatic fibrosis and echinococcus infection.
Liver cysts are usually asymptomatic, and most people having them are unaware about their condition. It is found that less than 5 percent of people with hepatic cysts develop noticeable symptoms. Also, the benign sacs don't affect the normal functioning of liver. When the cysts grows larger to about 7 cm, or if there is bleeding inside the cysts, then only they cause symptoms. Bleeding into the cysts is characterized by sudden pain in the upper right abdomen.
Symptoms associated with hepatic cysts include the following.
- Upper abdominal swelling and discomfort
- Abdominal pain
- Nauseated feeling
- Eruption of the cysts
- Digestive problems
- Shoulder pain
- Liver enlargement
- Blockage of bile ducts
- Infection of the bile ducts
Diagnosis and Treatment
Diagnosis of liver cysts is done when a patient undergoes a CT (Computed Tomography) scan or an ultrasound procedure of the abdomen. Usually, they are detected incidentally, while doing imaging tests for other abdominal problems. If required, examination of a sample of fluid from the cysts, biopsy of the affected tissues and blood test (for parasitic infection cases) is conducted. It is common that an individual has more than one cyst in the liver tissues and rarely, there are multiple cysts.
Since liver cysts don't disturb the normal functioning of the body, there are no significant treatment methods. In case, the cysts are big enough (for example more than 3 cm), it is advisable to go for a follow-up abdominal imaging to check the growth of cysts. People go for treatment of liver cysts only after they experience discomfort symptoms that disturb their normal routine. Treatment for the same is done by aspiration and/or surgical removal of the cysts.
Of the two available treatment methods, removal of the cysts via laparoscopic surgery is a more reliable intervention. Simple aspiration of the cysts is not recommended, as fluid tends to fill up the cysts after some time. In the surgery, 2-3 small excisions are made in the abdomen. With the help of laparoscope, a large part of the affected tissues including the cyst wall is removed, and the incisions sites are sutured. Laparoscopic surgery is also recommended, if the cysts prevent normal flow of bile juice to the small intestine.
This minimally invasive procedure requires 1-2 days hospital stay. Usually, candidates achieve full recovery within 2 weeks after the surgery. As the liver regenerates on its own, it recuperates successfully. In case, the cysts are infected, then treatment may include administration of antibiotics and other prescribed medications along with excision of the tissues and cysts. For people who have participated surgery for hepatic cyst treatment, recurrence rate is very low (almost negligible).
To conclude with, no specific treatment is needed for asymptomatic liver cysts. However, one should be aware about the complications of liver cysts, such as infection, jaundice (yellowing of the skin and sclera), bleeding into cyst (causing pain) and disturbance of the flow of bile juice. If anybody suspects that he/she has liver cysts, it is recommended to consult and seek advice from a physician so as to get proper medical attention. Except for the mild discomfort cases, hepatic cysts do not pose risks for liver cancer and liver failure.