Not parasitic cysts of a liver
- Symptoms of Not parasitic cysts of a liver
- Reasons of Not parasitic cysts of a liver
- Treatment of Not parasitic cysts of a liver
The disease meets rather often (about 1-2%, according to autopsy). Allocate the inborn (true) and acquired (false) cysts of a liver; they can be solitary and multiple. Inborn cysts are covered by a cubic or cylindrical epithelium from within; acquired - a layer of fibrous connecting fabric. The term "solitary cysts" is not absolutely successful as they can be and multiple, significantly differing from a liver polycystosis (at the last disease defeat of both hepatic lobes is always observed).
Carry so-called solitary cysts, a liver polycystosis, dermoids, retentsionny cysts and cystadenomas to true cysts. The polycystosis of a liver is the inborn, genetically determined disease. More than at a half of patients the polycystosis of a liver is combined with cystous changes in kidneys, a pancreas, lungs.
Symptoms of Not parasitic cysts of a liver:
Existence in a liver of not parasitic cysts does not cause clinical manifestations. On reaching the big sizes of a cyst can cause moderate pains in right hypochondrium and be defined at a palpation. Clinical symptoms of damage of a liver are shown generally at development of complications. Carry a rupture of a cyst, suppuration, hemorrhage in its gleam, a malignancy, torsion of the cyst which is located on "leg" to the most frequent complications. Seldom there is obturatsionny jaundice at a prelum a cyst of the main bilious channels. In late stages of development of a polycystosis of a liver at substitution of the most part of a parenchyma of body cysts symptoms of a liver failure, and in the presence of the accompanying polycystosis of kidneys - and a renal failure accrue. In this case forecast of a disease adverse.
The diagnosis is made on the basis of a complex of tool researches. Apply the same ways, as at other focal damages of a liver. At ultrasonography the solitary cyst looks as anekhogenny formation of a rounded or oval shape with equal accurate contours. The anekhogenny formations of rounded shape which are localized in both hepatic lobes are characteristic of a polycystosis of a liver multiple. At a computer tomography the solitary cyst of a liver comes to light in the form of education with accurate contours of low x-ray density.
In some cases it is quite difficult to differentiate not parasitic cyst of a liver from echinococcal. In these cases serological tests on an echinococcosis are very valuable.
Reasons of Not parasitic cysts of a liver:
Cysts happen inborn and acquired (false). Adventitious cysts are formed after earlier postponed injury of a liver and are a consequence of the organization of subcapsular or intramural hematomas.
Treatment of Not parasitic cysts of a liver:
The main ways of treatment of small solitary cysts - a puncture or drainage under control of ultrasonography or a computer tomography with the subsequent introduction to a gleam of sclerosing solution (96% of alcohol, 87% of solution of glycerin). It is necessary for induction of an aseptic necrosis of an internal epithelial vystilka and the subsequent obliteration of a cavity of a cyst. At the big and huge cysts causing a compression of internals carry out a liver resection together with a cyst or cyst enucleation, formation of an internal anastomosis (tsistoyeyunostomiya).
In recent years these operations are carried out rather seldom as even at huge cysts (more than 20 cm in the diameter) perhaps effective use of sclerosing therapy under ultrasonography control. The lethality at this intervention equals to zero, and the frequency of postoperative complications makes less than 0,5%.
At a polycystosis of a liver and real threat of development of a liver failure apply operation of windowing of cysts - excision of a part of walls of cysts with the subsequent destruction of their internal covers an electroknife or an out-of-focus beam of the laser. The purpose of operation is reduction of a prelum of a hepatic parenchyma cysts and the prevention of its further atrophy. The similar type of operation can be executed in the "closed" way under ultrasonography control (a puncture of cysts with the subsequent sclerotherapy) or laparoscopic (windowing). When using low-invasive techniques the frequency of postoperative complications and a lethality approaches zero.