Acute cholangitis caused by a huge hepatic simple cyst: a case report

Simple hepatic cysts are usually asymptomatic and rarely cause complications. Among the rare complications of liver cysts, intracystic hemorrhage is one of the most frequent, and can result in a rapid increase in cyst size. Some simple hepatic cysts may be large and can present with pressure effects, such as abdominal discomfort or obstructive jaundice. A 68-year-old female with a simple huge hepatic cyst was scheduled elective laparoscopic fenestration in 6 weeks. Before the operation, she developed acute cholangitis, resulting from an acute increase in cyst size due to intracystic hemorrhage. Upon open fenestration, 6.1 L of chocolate-like fluid was drained. A huge simple hepatic cyst complicated by intracystic hemorrhage resulted in an acute increase in cyst size. Distortion of the extrahepatic bile duct by the cyst obstructed the bile flow. Acute cholangitis was eventually developed.