Keywords
Hepatic surgery
Primary Health Care
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Abstract
Objective: To report the case of a patient with a giant simple hepatic cyst treated at a public hospital, highlighting the diagnostic process, therapeutic approach, and challenges in a resource-limited setting. Case details: A 62-year-old woman presented to the Primary Health Care Unit with progressive abdominal distension, fullness, and heartburn. Abdominal ultrasound revealed a large cystic lesion, later confirmed by CT scan as a giant hepatic cyst measuring over 30 cm and displacing adjacent organs. Due to the extreme size and technical limitations, open laparotomy with hepatic segmentectomy and unroofing was performed. Postoperatively, the patient developed a small biliary fistula managed conservatively. Histopathological analysis confirmed a simple cyst and chronic cholecystitis. The patient showed significant clinical improvement and remained asymptomatic during outpatient follow-up. Final considerations: This case reinforces the importance of clinical listening in Primary Health Care and the effective referral to specialized care. It also shows that, in low-resource contexts, open surgical management remains a safe and definitive option for giant hepatic cysts.
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