Highly symptomatic adult polycystic disease of the liver. A report of fifteen cases.

Fifteen patients were evaluated because of highly symptomatic adult polycystic liver disease. All of them had abdominal pain, two patients had obstructive jaundice, one had ascites and a large right-sided pleural effusion, and one had oesophageal varices. In 4 patients percutaneous aspiration of the largest cysts was performed, but this form of treatment only provided temporary relief. In 9 patients a fenestration operation was carried out. One of these patients died per-operatively due to irreversible shock. The abdominal complaints disappeared post-operatively in 7 of the other 8 patients, although a decrease of the liver span was uncommon. In the two patients with obstructive jaundice the serum bilirubin level normalized after the operation, and in the patient with oesophageal varices this abnormality disappeared post-operatively. Biochemical analysis of cyst fluid was performed in 7 of the cases. The mean ratios of the levels of most of the non-protein-bound inorganic ions and other small molecules in cyst fluid and serum were about 1, whereas those of all proteins and protein-bound constituents were generally far below 1.