Korean J Nephrol.  2008 Mar;27(2):256-259.

Hepatic Cyst Rupture in a Hemodialysis Patient with Polycystic Kidney Disease

Affiliations
  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. changwha@hanyang.ac.kr

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is usually accompanied with cystic change of other organs, especially in liver. Although hepatic cysts may be presented with abdominal pain or infected cysts, rupture of hepatic cyst is rarely encountered. A 74-year-old female undergoing maintenance hemodialysis for ADPKD-induced end stage renal disease was admitted because of abdominal pain. She recently received intermittent urokinase instillation into her cuffed internal jugular venous catheter. During the admission, a sudden onset of diffuse abdominal pain occurred after hemodialysis and repeated urokinase instillation. The abdominal CT revealed rupture of hepatic cysts with perihepatic fluid collection. With supportive care and heparin-free hemodialysis, symptoms were improved. The abdominal CT taken after 3 weeks showed no evidence of hepatic cyst rupture. The possibility of hepatic cyst rupture should be considered when abdominal pain occurs in dialysis patients with ADPKD. We need to be very cautious when they are exposed to anticoagulants or thrombolytic agents.

Keyword

Polycystic kidney disease; Cyst; Rupture; Hemodialysis

MeSH Terms

Abdominal Pain
Aged
Anticoagulants
Catheters
Dialysis
Female
Fibrinolytic Agents
Humans
Kidney Failure, Chronic
Liver
Polycystic Kidney Diseases
Polycystic Kidney, Autosomal Dominant
Renal Dialysis
Rupture
Urokinase-Type Plasminogen Activator
Anticoagulants
Fibrinolytic Agents
Urokinase-Type Plasminogen Activator
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