Rapid enlargement of a hepatic hilar cyst leading to bile duct obstruction after acute exacerbation of chronic hepatitis B

Tomoaki Iwata, Jun Inoue, Eiji Kakazu, Masashi Ninomiya, Akitoshi Sano, Mio Tsuruoka, Kiyoshi Kume, Atsushi Masamune

Research output: Contribution to journalArticlepeer-review

Abstract

A hepatic cyst is usually asymptomatic but, in some cases, can be associated with various complications. Here we report a rare case with rapid enlargement of a hepatic hilar cyst that induced bile duct obstruction after an acute exacerbation of chronic hepatitis B. The case is a 60-year old female who discontinued entecavir by herself. Hyperbilirubinemia was prolonged along with bile duct obstruction due to an enlarged cyst. After the administration of entecavir and steroid pulse therapy, biliary drainage and punctuation of the cyst were performed. There was no evidence of malignancy in the cyst. The therapies were not effective enough, probably due to the prior liver damage, and she died of acute on chronic liver failure. This case suggests that a hepatic hilar cyst in a patient with acute hepatitis or an acute exacerbation of chronic hepatitis can become enlarged and may affect the clinical course of hepatitis. In such a case, the size of the cyst should be monitored frequently and bile duct obstruction should be treated early if it occurs.

Original languageEnglish
Pages (from-to)1247-1251
Number of pages5
JournalClinical Journal of Gastroenterology
Volume13
Issue number6
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Acute on chronic liver failure
  • Entecavir
  • Hepatic cyst
  • Hepatitis B virus

ASJC Scopus subject areas

  • Gastroenterology

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