A case with successful hemostasis after transcatheter arterial embolization for giant simple liver cyst accompanied by rupture and intraperitoneal bleeding after an abdominal bruise

Abstract

An 80-year-old female with an asymptomatic, 15-cm diameter, giant simple liver cyst had bruised the right side of her body. Computed tomography performed for her abdominal distension revealed the ruptured liver cyst and ascites. Four days later, this patient was admitted for worsening anemia. Paracentesis showed bloody ascites, and we determined that the bleeding was from the ruptured cyst. Hepatic angiography revealed no extravasation, but stains in the periphery of the right anterior segmental artery and right posterior superior segmental branch were thought to be the bleeding points. Transcatheter arterial embolization (TAE) of those branches was subsequently performed, and the anemia improved. Furthermore, the patency of the large hiatus of the cyst, which had an effect similar to a fenestration for a giant liver cyst, might have decreased the size of the liver cyst. This case indicated that TAE is a nonoperative management option for bleeding from ruptured liver cysts.