Polycystic liver disease is a rare hereditary disease. Many people with this disorder have hereditary polycystic kidney disease as well. In this liver disease, people have many liver cysts and yet often have no symptoms. For those who do have symptoms, these typically manifest as hemorrhaging, infections, fractured rib, back pain or a prolapsed uterus.
Discontinue Estrogen Use
Estrogen may make the cysts increase in size, according to Qi Qian, M.D., assistant professor at the Mayo Clinic School of Medicine in a 2009 issue of "Current Diagnosis & Treatment: Nephrology & Hypertension." There are more women with this liver disease than men; women typically are afflicted with more cysts as well. Therefore, women with polycystic liver disease who are taking estrogen replacement therapy or oral contraceptives may need to stop taking these medications if their physician feels that the risk of having the liver cysts enlarge is too great.
Cyst Aspiration and Sclerotherapy
Aspiration of these cysts may be prescribed in cases in which there are just a few problematic cysts. The surgeon will aspirate, or drain, the fluid from the cyst, using an ultrasound or CT as a guide. The surgeon will then perform sclerotherapy, a procedure in which the area is injected with a substance that makes it hard. This decreases the likelihood that the cyst will refill with fluid.
Fenestration
Another treatment for polycystic liver disease is fenestration of the liver cysts. Fenestration is the medical term for making an opening in a tissue or structure. This is done with a laparoscope or through open surgery. A laparoscope is an instrument that has a small camera at the end. In laparoscopy, the surgeon only needs to make small cuts for the laparoscope and other instruments. In open surgery, the surgeon must cut open the abdomen. In either case, after the procedure the wall of the cyst is sent to the pathology lab to check for any signs of cancer.
"Schwartz's Principles of Surgery," says that laparoscopic fenestration is more common than open surgery and is 90 percent effective in treating polycystic liver disease.
Treat the Infection
Qian explains in "Current Diagnosis & Treatment: Nephrology & Hypertension" that if the physician feels that there are infected cysts, the cysts are aspirated to verify that there is an infection. They will need to be drained and the patient will need antibiotics. The lab takes the fluid and makes a cyst-fluid culture which will determine if there are any bacteria in the cyst fluid. If so, additional tests will show which bacteria are causing the infection and the physician can then prescribe an antibiotic to kill that particular bacterium.
References
- "Current Diagnosis & Treatment: Nephrology & Hypertension"; Edgar Lerma, M.D., Jeffrey Berns, M.D., Allen Nissenson, M.D.; 2009
- "Schwartz's Principles of Surgery"; F. Charles Brunicardi, M.D.; 2010
