Contributed by Manuel Suarez, MD and Sheldon Bastacky, MD
Published on line in February 1999
The patient was a 31-year-old female who is 35 weeks pregnant with a right upper quadrant cyst diagnosed but ultrasound and initially thought to be a liver cyst. The patient began having significant right upper quadrant pain. Approximately two liters of serosanguineous fluid were aspirated from the cyst under ultrasound guidance, after which she developed dizziness and orthostatic hypotension. A repeat ultrasound examination showed re-accumulation of cyst fluid consistent with significant bleeding into the cyst. At this point it was decided to induce delivery. After delivering a healthy 35-week female a CT scan of the abdomen showed a large cyst in the right adrenal gland. Drainage and resection of the adrenal cyst were performed.
An abdominal CT scan revealed a large right upper quadrant cyst measuring 14x17x21 cm ( lateral, anteroposterior and craniocaudal)(Images 01 and 02). There was mass effect upon the liver and duodenum. The cyst had a thin smooth wall with internal fluid and high density material consistent with a blood clot.