Application of subharmonic‐aided pressure estimation in a patient with giant hepatic cyst: A case report

Abstract

AbstractGiant hepatic cysts may lead to impaired liver function by compressing surrounding tissue, resulting in symptoms such as nausea or portal hypertension. Subharmonic‐aided pressure estimation (SHAPE) offers a noninvasive method for quantitatively estimating pressure and monitoring interstitial fluid pressure. A 55‐year‐old female patient with giant hepatic cysts was admitted to our hospital with elevated protein electrophoretic gamma levels, likely caused by compression of important liver vessels by the cysts. Before surgery, B‐mode ultrasound (BMUS) revealed multiple anechoic cystic lesions with thin, smooth walls in the right lobe. In SHAPE, the curve of the portal vein was lower than that of the hepatic vein, which is absolutely different from a healthy volunteer in our previous SHAPE study. It suggested that the patient may have had portal hypertension. Three days after laparoscopic fenestration and drainage of hepatic cysts, the size of the largest cyst had decreased on BMUS and protein electrophoretic gamma levels had normalized. While the curve of the portal vein remained lower than that of the hepatic vein, the difference between them had decreased compared to presurgery levels. SHAPE shows promise as a tool for noninvasively estimating portal hypertension and improving prognosis assessment in patients.