Intracystic hemorrhage with spontaneous rupture of liver cyst complicated by infection: a case report.

A 78-year-old man who was being followed-up for a liver cyst was admitted to Asakayama General Hospital because of the sudden onset of severe right hypochondralgia and fever, with a preceding dull pain in the right upper quadrant of the abdomen of four 'days' duration. Computed tomography revealed remarkable enlargement of the liver cyst. We diagnosed intracystic hemorrhage and spontaneous rupture of the liver cyst. As we diagnosed bacterial infection in the ruptured cyst, transhepatic cystic drainage was performed. After improving the clinical status of the patient, we injected ethanol into the cyst, inducing a significant decrease in its size. There has been a few previous reports of intracystic hemorrhage and spontaneous rupture of a liver cyst complicated by infection. Transhepatic cyst drainage combined with antibiotic therapy and intracystic ethanol injection may be a useful and minimally invasive method for liver cysts with these complications, especially in compromised patients.