Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
Clin J Gastroenterol. 2024 Dec;17(6):1100-1105. doi: 10.1007/s12328-024-02028-4. Epub 2024 Aug 5.
A 72 year-old male patient with a history of a hepatic cyst presented to our hospital with epigastric pain. The cyst had enlarged to approximately 130 mm and was diagnosed as a symptomatic hepatic cyst. Percutaneous cyst drainage was deemed challenging because of the risk of intestinal perforation; therefore, transgastric endoscopic ultrasound-guided hepatic cyst drainage was performed with external nasal cyst drainage. After cyst shrinkage was confirmed, minocycline hydrochloride was injected into the cyst through the nasal drainage tube, and the nasal cyst drainage was removed. Nine months after treatment, the cyst diameter markedly reduced to 12 mm on computed tomography, and the symptoms improved. In cases where surgery is complex or it is difficult to secure a percutaneous puncture line, endoscopic ultrasound-guided drainage and minocycline hydrochloride injection may be effective if a puncture route can be secured under endoscopic ultrasound.
一位 72 岁男性患者，有肝囊肿病史，因上腹痛就诊于我院。囊肿增大至约 130mm，诊断为症状性肝囊肿。由于存在肠穿孔的风险，经皮囊肿引流术具有挑战性；因此，行经胃内镜超声引导下肝囊肿引流术，并进行外置鼻腔囊肿引流。确认囊肿缩小后，通过鼻引流管向囊肿内注入盐酸米诺环素，然后拔除鼻引流管。治疗 9 个月后，CT 显示囊肿直径明显缩小至 12mm，症状改善。对于手术复杂或难以确定经皮穿刺线的情况，如果能够在超声内镜下确定穿刺路径，超声内镜引导下引流和盐酸米诺环素注射可能是有效的。
