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Hepatic Cyst: An Unusual Suspect of Syncope
Joint Authors
Choudhry, Mohammad K.
Xiong, Bei
Anandaraj, Antony
Trillo, John
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-02-28
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
The patient is a 75-year-old man with history of diabetes and hypertension who presented with syncope after experiencing sharp, 10/10 right flank and abdominal pain worsening over three weeks associated with decreased appetite.
Physical examination revealed hepatomegaly and right lower quadrant (RUQ) tenderness, negative for peritoneal signs.
Bloodwork showed leukocytosis (13 K/mcl), alkaline phosphatase (141 U/L), total bilirubin (2.0 mg/dL), and gamma-glutamyl transferase (172 U/L).
Computed Tomography (CT) revealed multiple hepatic cysts with the largest measuring 17 × 14 × 18 cm (Figure 1).
Parenteral opiates provided minimal relief.
Cardiac and neurologic etiologies of syncope were ruled out.
The patient’s course was complicated by opioid-induced delirium as his abdominal pain progressively worsened despite escalating doses of parenteral and oral analgesics.
Gastroenterology and interventional radiology consulted to evaluate for Glisson’s capsular stretch.
Therapeutic aspiration yielded 2.5 L of serous fluid, which alleviated the patient’s pain.
Cytology was negative for malignancy.
Opiates were titrated down.
Repeat CT (Figure 2) showed cysts that were significantly reduced in size.
The patient showed complete resolution of symptoms and was subsequently discharged.
We present a rare case of a large hepatic cyst causing syncope.
In the appropriate clinical setting, syncope with RUQ tenderness and hepatomegaly should raise the index of suspicion for hepatic cysts.
American Psychological Association (APA)
Choudhry, Mohammad K.& Xiong, Bei& Anandaraj, Antony& Trillo, John. 2020. Hepatic Cyst: An Unusual Suspect of Syncope. Case Reports in Hepatology،Vol. 2020, no. 2020, pp.1-3.
https://search.emarefa.net/detail/BIM-1147918
Modern Language Association (MLA)
Choudhry, Mohammad K.…[et al.]. Hepatic Cyst: An Unusual Suspect of Syncope. Case Reports in Hepatology No. 2020 (2020), pp.1-3.
https://search.emarefa.net/detail/BIM-1147918
American Medical Association (AMA)
Choudhry, Mohammad K.& Xiong, Bei& Anandaraj, Antony& Trillo, John. Hepatic Cyst: An Unusual Suspect of Syncope. Case Reports in Hepatology. 2020. Vol. 2020, no. 2020, pp.1-3.
https://search.emarefa.net/detail/BIM-1147918
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1147918