Successful Laparoscopic Deroofing and Hemostasis for Spontaneous Rupture of a Hemorrhagic Hepatic Cyst: A Case Report

Abstract

The patient was a 79-year-old man who presented to our emergency department complaining of acute severe epigastric pain. There was no history of trauma. The patient was hemodynamically stable, and laboratory tests revealed mild anemia. Dynamic abdominal CT showed a collapsed hepatic cyst in segment 2 of the liver, with elevated attenuation values in both the cystic fluid and the surrounding ascitic fluid. Diagnostic paracentesis confirmed hemoperitoneum, based on which we made the diagnosis of spontaneous rupture of a hemorrhagic hepatic cyst. Laparoscopic deroofing and hemostasis were performed, with the patient successfully saved. Laparoscopic surgery offers advantages such as eliminating blind spots through insertion of the laparoscope into the cyst and facilitating precise identification of bleeding points through magnified visualization. Despite its benefits, however, reports of laparoscopic intervention for ruptured hepatic cysts are limited. This case report highlights the diagnostic considerations in this patient, as well as the advantages and limitations of a laparoscopic surgical approach, with a review of the relevant literature.