CAZURI CLINICE - CASE STUDIES
UNUSUAL CASE OF POLYCYSTIC LIVER DISEASE
Andreea Brumaru, Catalina Mihai, Cristina Cijevschi Prelipcean
Institute of Gastroenterology and Hepatology
University of Medicine and Pharmacy „Gr.T. Popa” Iasi
Jurnalul de chirurgie 2005; 1 (1):87-91
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Abstract:
Polycystic liver disease (PCLD) is a rare disease defined as the presence
of four or more thin-walled cyst within the hepatic parenchyma.The
most common form of autosomal dominant PCLD coexist with renal cystic
disease. In contrast to the concomitant renal and liver cystic disease,
the isolated form of PCLD is a comparatively rare form, that displays
no renal involvement.Only 7% of patients with PCDL do not have associated
renal cyst.
Most cases are asymptomatic. Patients generally have preserved hepatic
functions.The liver function tests are normal. Polycystic liver is
rarely associated with portal hypertension , obstructive jaundice
or infection of hepatic cysts. Autopsy series show that 20 % of patients
with PCLD have associated intracranial aneurism.
There are no effective medical therapies for PCLD.Surgical options
for those with refractory symptoms or complications include percutaneous
puncture and sclerosys of cysts, cysts fenestration by open or laparoscopic
technique, hepatic resection, and isolated hepatic or combined liver
kidney transplantation.
We present the case of a 68 years male subject , diagnosed with alcoholic
liver cirrhosis based on the chronic alcohol consumption,negative
serological markers for the B and C hepatitis viruses, hepatoprive
and biliar retention tests, portal hypertension. The abdominal echography
revealed a diffuse enlargement of the liver , witch contains numerous
cysts scattered throughout the liver.
The cysts vary in size from less than 1 cm to more than 5 cm. There
is no evidence of renal or pancreatic cysts. The treatment is addressed
to the portal hypertension due to alcoholic liver disease. The PCLD
is not complicated and therefore requires no surgical treatment.
KEYWORDS: POLYCYSTIC LIVER DISEASE, ALCOHOLIC LIVER CIRRHOSIS
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