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Polycystic livers occur in the setting of two inherited conditions: (1) autosomal dominant polycystic kidney disease (ADPKD), also characterised by progressive development of renal cysts resulting in loss of renal function, and (2) polycystic liver disease (PCLD), with a polycystic liver as the sole manifestation. Symptoms, such as abdominal distension, result from hepatomegaly. Ascites is a rare complication and might be due to portal hypertension or caused by a ruptured cyst.
Treatment strategies for polycystic livers are aimed at reducing liver volume. So far, only surgical options are available, but these are associated by considerable morbidity and mortality.1 Alternatively, ascites in the setting of polycystic livers might respond to endovascular stent placement in the narrowed caval vein,2 but medical options are conspicuously lacking so far. We wish to report two cases with severe polycystic liver …
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