A CASE OF INFECTED LIVER CYST

An 81-year-old man was seen at the hospital because of upper abdominal pain and general fatigue. Physical examination showed tenderness in the epigastric region. Blood laboratory data revealed that the white blood cells count was 14, 470/mm3, C-reactive protein was 15.3mg/dl, CEA was 0.5ng/ml and CA19-9 was 2.00U/ml. Abdominal ultrasonography and CT scan revealed multilocation and homogeneous cystic lesion 15cm in diameter in the lateral segment of the liver. Because of unsuccessful antibiotics administration for his inflammation, percutaneous transhepatic drainage of the liver cyst guided by ultrasonography was carried out. The cyst contained yellow milky fluid with inconsequential cloud, 680ml in amount, in which CEA was 71.6ng/ml and CA19-9 was 2000U/ml. Of the fluid of the liver cyst, cultures for bacteria or fungi were negative, and a cytology indicated Class I with numerous neutrophils. Inflammatory findings were gradually improved after the drainage of the cyst. Cystography was not able to detect a communication between the cyst and the bilialy tract. It is crucially rare that infection intervenes in the liver cyst, we report this case of infected liver cyst which was successfully managed by percutaneous transhepatic drainage.