A Case of an Infected Small Liver Cyst following Pancreatoduodenectomy

Abstract

A 70-year-old man was admitted to our hospital due to a high fever. A diagnosis of cholangitis following pancreatoduodenectomy (postoperative day 66) was suspected. Abdominal ultrasonography and computed tomography (CT) showed an infected liver cyst, the diameter of which changed from 33 to 36 mm. We performed percutaneous drainage of the liver mass, and a culture of the discharge revealed the presence of E. coli. A contrast test of the cyst showed no connection between the cyst and the biliary tree, and then absolute ethanol was injected into the lesion. The liver cyst disappeared, and the patient has had no further complaints of high fever. Asymptomatic liver cysts are common clinical entities that do not usually require treatment. When patients with liver cysts who have undergone reconstruction of the biliary tree complain of a high fever, physicians should consider a diagnosis of cholangitis and an infected liver cyst, even if the cyst is small. In addition, physicians should consider performing fenestration of giant liver cysts during the first operation.