HEPATIC CYSTS PARASITIC CONGENITAL

Hepatic cysts (HC) can be either parasitic (echinococcal) following infestation in endemic regions, acquired (after trauma or inflammatory processes), or nonparasitic (congenital) in nature.
- Congenital nonparasitic hepatic cysts are uncommon, solitary, benign lesions that arise from aberrant development of intrahepatic biliary radicals after ischemic thrombo-embolic phenomena (vascular disruption theory). The cyst is lined with cuboidal or squamous epithelium, and there is a female and white children predominance. Although generally asymptomatic, children may manifest increased abdominal girth, vague abdominal discomfort, infection, or obstructive jaundice.

Ultrasound and CT-Scan are diagnostic tools.

Management may consist of: simple unroofing, complete removal by enucleation or hepatic lobectomy, internal Roux-en-Y drainage, or percutaneous aspiration and sclerosis (alcohol, minocycline). The surgical alternative to use will depend on size, location (central, peripheral or dumbbell), and presence of communication with biliary system of the cyst (see figure). Some cases diagnosed prenatally or during the neonatal period have undergone slow spontaneous regression.