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Does a septated hepatic cyst always need to be removed by surgery?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Does a septated hepatic cyst always need to be removed by surgery? Doctors recently found a septated cyst through ultrasound. Last year a cyst was drained to rule out echinoccocus or some kind of ameba or abscess based upon some travel to Africa. The fluid showed no infection. Doctors found a septated cyst last week during an ultrasound for something else. I am having a CT tomorrow. Are septated cysts always removed surgically? Could my cyst from last year have changed to a septated cyst or could a blood clot have formed to make it look like a septated cyst? . It is 3.4x2.8x3.6 with no associated vascularity. I am getting a CT tomorrow and seeing a hepatologist on Wednesday.
Posted Mon, 13 Aug 2012 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 6 hours later
Thanks for writing in.
A parasitic cyst usually takes a lot of time to grow, especially a hydatid cyst. These are septate and have XXXXXXX echoes.The treatment for hydatid or echinococcal cyst is removal. The other cause is a abscess cavity due to amoebiasis infection. That requires just aspiration and medical treatment only. Now the best investigation for liver lesions would be a double contrast CT of the abdomen. This will help in determining whether there is a chance of malignancy. Another supportive test would be determination of alpha fetoprotein levels in blood which point towards a liver malignancy. If the results are equivocal and the cyst not deeply located then a resection would be advisable.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
Follow-up: Does a septated hepatic cyst always need to be removed by surgery? 3 hours later
Thank you but there is no evidence of parasitic infection or echonococcus. Can you answer my question about whether the change in shape could have been caused by the drainage in November or whether it is possible that a blood clot could have formed
If that is the reason for change of shape should it still be removed? Also I have read about connections with birth control which I have been on for about 25 years. Could that cause this kind of cyst? If it has to be removed, what is the typical recovery time in hospital and at home assuming no complications.
Answered by Dr. Ketan Vagholkar 4 hours later
Thanks for the feedback.
Yes aspiration can alter the morphology of the lesion.The nature of the contents aspirated then would have lead one to accept the chance of there being a blood clot.
Oral contraceptive pills can cause a condition called peliosis hepatis wherein multiple blood filled spaces develop within the liver. Hemangiomas may also be present snce birth. Such type of lesions do not require any surgical treatment whatsoever.
A contrst enhanced CT can prove any of these lesions without doubt.
If resected the duration of stay in hospital would be about 7 -9 day s if all is well.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
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