How To Diagnose And Treat Liver Cysts

May 27, 2023

Also known as hepatic cysts, liver cysts are believed to affect approximately five percent of individuals in the United States. The cysts are small sacs of fluid that form on the liver, and the majority of patients will have only a single cyst. Most liver cysts produce no symptoms and require no treatment. If symptoms do develop, these may include abdominal fullness or pain. If bleeding into the liver cyst occurs, patients could experience severe pain in the upper right quadrant of the abdomen, and this pain may radiate to the shoulder. Hepatic cysts cause no issues with liver function. In cases where treatment is necessary, doctors normally recommend removal of the cysts or cyst wall. Medications known as somatostatin analogs are currently being researched as a nonsurgical treatment option.

The major methods of diagnosis and treatment for liver cysts are outlined below.

Ultrasound

Ultrasound scans are a primary method for detecting liver cysts. These painless scans use high-frequency sound waves to produce images, and there is no radiation involved. To create an ultrasound image of the liver, the sonographer will place a gel on the patient's skin, and a transducer (wand) is then placed on the skin over the liver itself. Ultrasounds can be performed in clinics and hospitals, and they normally take around twenty to sixty minutes. Patients having an ultrasound of the liver may be asked to fast for a few hours before their appointment; this will help produce a clearer image. Individuals allergic to latex should tell the provider about this allergy so a non-latex cover can be used for the transducer. A few days after the scan is complete, a radiologist or other specialist will explain the results to the patient.

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CT Scans

CT scans take multiple x-rays from several angles, and computer processing is then used to create cross-sectional images, also known as slices. These slices can help doctors diagnose cysts and other liver diseases, and they are also useful in planning treatment and mapping out potential surgical intervention. Before having a CT scan, the patient will need to change into a hospital gown. If the physician has ordered contrast to be used to improve the quality of the images, the patient may be given an oral solution to drink containing a dye that will appear white on the images. This dye could be administered via injection instead. Sometimes, patients might be asked to fast in preparation for the scan. CT scans normally take roughly thirty minutes in all, and this time includes positioning the patient in the scanner and the scanning process itself. To help doctors obtain clear images, the radiologist may ask the patient to hold their breath for a few moments during the scan. If contrast was used, special instructions will be provided on what to expect after the procedure. It can be helpful to drink plenty of fluids to promote the removal of the dye from the body through urination.

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Blood Tests

Blood tests help doctors measure liver function, and they provide additional diagnostic clues about potential cancers and other liver issues. For example, some liver cysts are caused by a parasite known as echinococcus, which is primarily carried by sheep, and a blood test is necessary to detect it. Blood tests can be performed by nurses, phlebotomists, and other medical professionals. Patients who are afraid of needles may wish to use a prescription numbing cream prior to having this test. To take a blood sample, the healthcare professional places a tourniquet around the patient's upper arm and cleans their skin with an alcohol swab. Next, they insert a needle into a vein, normally one near the crease of the elbow. After enough blood has been collected, the needle is removed, and a bandage is placed over the site. Patients who are nervous before the procedure might wish to lie down during their test to reduce the risk of fainting. Blood test results are normally available within a week, and patients will be called if there are any abnormalities.

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Cyst Drainage

Cyst drainage is a minimally invasive procedure that could provide temporary relief for patients experiencing symptoms due to liver cysts. To perform this procedure, doctors give the patient a local anesthetic to prevent pain. Next, a thin needle is inserted into the patient's liver. The doctor will advance the needle until it reaches the cyst, and this is usually done with ultrasound guidance. Once the healthcare professional has confirmed the needle is in the right location, they will withdraw fluid from the cyst, draining it completely. The needle is then removed, and a sterile dressing is placed over the area. In general, doctors only recommend cyst drainage as a temporary measure; the cysts will normally fill up with fluid again as time progresses.

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Surgical Removal

Surgical removal is considered the most effective treatment method for liver cysts causing symptoms. Unlike cyst drainage, it permanently removes the cysts so they will not reform. Where possible, doctors prefer to use laparoscopic methods for this procedure. These methods cause less scarring and pain, and patients also have a quicker recovery time. After giving the patient a general anesthetic, doctors will make two or three small incisions in the abdomen. Surgical equipment is inserted into these incisions, and a camera is also inserted to allow surgeons to visualize the entire area. After the operation, patients will be monitored in a recovery area, and an overnight stay in the hospital is normally required. During their stay, patients will be assessed for bleeding, and their surgical dressings will be changed. Patients are typically discharged the following day, and most of them make a full recovery within two weeks. A follow-up appointment will be scheduled to evaluate the patient's progress, and any concerns or new symptoms should be reported to the surgeon as promptly as possible.

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