Emergency laparoscopic treated the spontaneous bleeding and cystobiliary communication of multiple liver cysts

Abstract

Rupture of non-parasitic liver cysts is rare, especially with hemorrhage, biliary communication, and a large amount of fluid in the abdominal cavity.1 We report the case of an elderly patient with a liver cyst with bleeding and biliary communication that spontaneously ruptured and was successfully treated by laparoscopic deroofing and closure of the communication. A 74-year-old man was admitted to the emergency center with sudden right upper abdominal pain for 24 h duration. His abdominal pain was full and persistent, without radiating pain, diarrhea, vomiting and fever. No blood in the stool and urine. His vital signs were as follows: T, 36.7 C; P, 95/min; R, 26/min; BP, 160/93 mmHg and oxygen saturation, 96%. The shape of abdomen was normal, the right upper abdomen was tender, no rebound pain, the liver wasn’t palpable. Non-coagulated blood was drawn out by diagnostic abdominal puncture. He had discovered liver multiple cysts 5 years ago, the largest diameter was about 4.5 cm in 2014, and then it had been growing slowly without abdominal symptoms. This elderly patient has a history of chronic bronchitis, emphysema, hypertension, and renal insufficiency, all of which were well controlled and taken drugs regularly.