Conservative Management of a Ruptured Simple Hepatic Cyst: A Case Report

Simple hepatic cysts are common benign liver lesions that are typically asymptomatic and discovered incidentally. They are generally managed conservatively unless symptoms or complications develop. Spontaneous rupture of a hepatic cyst is exceptionally rare and often necessitates surgical or interventional management. We report the case of a 79-year-old woman with a large known hepatic cyst who presented with acute right upper quadrant pain, nausea, and vomiting. Imaging revealed rupture of the cyst with associated perihepatic free fluid, but no evidence of haemorrhage or infection. Given her haemodynamic stability and absence of sepsis, a conservative approach was adopted. She was managed with close observation, supportive care, and analgesia, without the need for surgical or percutaneous intervention. The patient remained clinically stable, her symptoms resolved gradually, and she was discharged home in good condition. This case demonstrates that conservative management can be a safe and effective option in carefully selected patients with ruptured simple hepatic cysts, particularly those who are haemodynamically stable and without evidence of infection or bleeding. Early imaging, multidisciplinary input, and vigilant clinical monitoring are key to successful non-operative outcomes.