Recurrent Renovascular Hypertension due to Giant Liver Cyst

Andrew W. Michael, MD, Peter F. Rovito, MD, Peter V. Rovito, BS

Department of Surgery, Lehigh Valley Health Network, Allentown, PA, USA (Dr. Michael). Department of Surgery, Sacred Heart Hospital, Allentown, PA, USA (Drs. Rovito and Rovito).

ABSTRACT

Introduction: Renovascular hypertension is a rare but treatable cause of refractory hypertension and is usually the result of fibromuscular dysplasia or atherosclerotic disease. Infrequently, renovascular hypertension is caused by external compression due to enlarged adjacent structures, such as lymph nodes or adrenal tumors.

Case Description: We present an unusual case of a giant liver cyst that compressed the renal artery and caused subsequent renovascular hypertension that was treated with multiple drainage procedures, with eventual resolution of the patient’s symptoms.

Discussion: The application of laparoscopic cyst drainage with adjuncts such as drain placement and sclerosing agents is useful for complete long-term resolution of large hepatic cysts. Resolution of the patient’s hypertension indicates renovascular hypertension secondary to the cyst as the etiology of her symptoms.

Key Words: Hepatic, Cyst, Renovascular hypertension, Drainage.

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