Author ORCID Identifier
https://orcid.org/0009-0006-9300-8969
Abstract
Hemorrhage into a simple hepatic cyst often results in development of a complex cystic lesion, which makes this identical to a cystic tumor. We present a striking example of this decision-making in a patient with suspected intracystic hemorrhage from recent anti-platelet medication use post-percutaneous coronary intervention (PCI). 83-year-old male presented to the hospital with acute right upper quadrant (RUQ) abdominal pain, severe and constant. This was associated with nausea and constipation. Medical history was significant for recent PCI and initiation of dual anti-platelet therapy (DAPT) ten days ago, and chronic thrombocytopenia. Ultrasound and CT confirmed complex 12.8 x 11.4 x 12.4 cm hepatic cyst, with suspected, intracystic hemorrhage of a simple liver cyst. Given failed conservative management, surgical route was opted. Laparoscopic fenestration of the cyst yielded a large volume of bloody material confirming the diagnosis. Biopsy of the cyst wall showed simple liver cyst with an adherent blood clot. Aspirin was resumed post-operatively, and ticagrelor was continued throughout given the high risk of stent thrombosis. Intracystic hemorrhage in a simple liver cyst, though rare, is a possible complication of DAPT use after PCI. Further use of DAPT usually requires tailored approach to patient’s coronary anatomy, nature of stent used, underlying risk factors and type of bleed.
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Recommended Citation
Naeem N, Takla A, Vallabhajosyula S, Jadhav NR. Intracystic Hemorrhage In A Simple Liver Cyst Due To Dual Anti-Platelet Therapy After Percutaneous Coronary Intervention. Advances in Clinical Medical Research and Healthcare Delivery. 2024; 4(1). doi: 10.53785/2769-2779.1170.