What’s the diagnosis? Comment your guesses before reading the answer below the hashtags.
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40 year old female presents with right upper quadrant abdominal pain that she’s had for the past two years. It is worse when she eats fatty foods. An ultrasound showed gallstones and a left liver mass. The video is taken during her laparoscopic cholecystectomy.
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#gallbae #awyeah #specimenslam #liver #gallbladdersurgery #gallbladder #chole #cyst #cysts #pimple #pimples #pimplepopper #anatomy # nurse #nurses #surgery #surgeon #premed #medstudent #medschool
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Diagnosis: Large, simple hepatic cyst of the left lobe of the liver.
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It is not possible to tell what a liver mass is just by looking at it from outside, as seen in the video. However, the two most common liver masses are fluid filled cysts and blood vessel tumors called hemangiomas. Hemangiomas are more purplish and can look like a ball of noodles. Pre-operative imaging showed that this was a large, simple cyst. Either way, you should not poke or pop this thing. If this were a hemangioma, it would be very difficult to control bleeding during a laparoscopic surgery. Liver masses can also be infectious (hydatid cysts), or cancerous (metastasis).
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The main point is, liver pathology is usually known before going into a surgery. So if a liver mass is found incidentally during an unrelated surgery, you need to make sure it is safe and appropriate to do a biopsy right then and there. Otherwise, leave it alone and order an ultrasound and CT abdomen with IV contrast to get a better idea of what it is.