TY - JOUR A2 - Irisawa，淳AU - 乔德里，穆罕默德K. AU - 熊，北盟 - 阿南达拉杰，安东尼AU - 特略，约翰PY - 2020 DA - 2020年2月28日TI - 肝囊肿：一个不寻常的可疑晕厥SP - 1659718 VL - 2020 AB - 该患者是一名75岁的男子与糖尿病和高血压病史谁遇到尖锐，10/10，右腰部和腹部疼痛伴食欲下降有关三个星期后恶化晕厥呈现。体检发现肝肿大，右下腹（RUQ）压痛，负腹膜的迹象。Bloodwork showed leukocytosis (13 K/mcl), alkaline phosphatase (141 U/L), total bilirubin (2.0 mg/dL), and gamma-glutamyl transferase (172 U/L). Computed Tomography (CT) revealed multiple hepatic cysts with the largest measuring 17 × 14 × 18 cm (Figure 1). Parenteral opiates provided minimal relief. Cardiac and neurologic etiologies of syncope were ruled out. The patient’s course was complicated by opioid-induced delirium as his abdominal pain progressively worsened despite escalating doses of parenteral and oral analgesics. Gastroenterology and interventional radiology consulted to evaluate for Glisson’s capsular stretch. Therapeutic aspiration yielded 2.5 L of serous fluid, which alleviated the patient’s pain. Cytology was negative for malignancy. Opiates were titrated down. Repeat CT (Figure 2) showed cysts that were significantly reduced in size. The patient showed complete resolution of symptoms and was subsequently discharged. We present a rare case of a large hepatic cyst causing syncope. In the appropriate clinical setting, syncope with RUQ tenderness and hepatomegaly should raise the index of suspicion for hepatic cysts. SN - 2090-6587 UR - https://doi.org/10.1155/2020/1659718 DO - 10.1155/2020/1659718 JF - Case Reports in Hepatology PB - Hindawi KW - ER -