An Infected Liver Cyst Treated with Combination of Percutaneous Transhepatic Abscess Drainage and Ethanol Injections: A Case Report

Abstract

An 84-year-old man was admitted to Kawaguchi Municipal Medical Center with a high fever and epigastric pain. The patient was suspected of having an infected liver cyst (ILC) based on the findings of abdominal computed tomography (CT) and a hematological examination. The CT findings demonstrated a 70-mm cyst containing fluid with a thick wall in the lateral segment of the liver. Percutaneous transhepatic abscess drainage (PTAD) was performed. The patient was discharged in 10 days. Five month later, the patient was re-admitted due to recurrent ILC, for which PTAD was carried out again. Moreover, the patient underwent minocycline injection therapy four times. However, in a further 2 months he developed the third ILC, for which ethanol injection was performed. Finally, a total of three injections were performed every two days after cystography revealed no communication between the cyst and the biliary tract. Ethanol injections successfully reduced the fluid production of the cyst without recurrence for the last nine months. For refractory ILC, ethanol injections may be a good treatment modality.