SummaryTwo cases are described of hepatic fibropolycystic disease (Brunt, 1973 The liver had a smooth capsule and was firm to the knife. The cut surface had a mosaic appearance with brown areas of liver tissue being broken up by white bands of fibrous tissue. There were no obvious cysts.On microscopy, the findings were typical of congenital hepatic fibrosis with strands of fibrous tissue within the portal tracts. The bile ducts appeared to be proliferating and there was some evidence of biliary stasis (Fig. 2).The capsules of the kidneys were adherent. The cortices measured up to 5 mm in thickness and were sponge-like. The cysts in the kidneys were up to 2 cm in diameter and some contained green pus and necrotic debris. On histology in the cortices there was fibrosis around the glomeruli which were sparse (Fig. 3). There were many cysts lined with flattened epithelium, and some of these contained casts. In the smaller right kidney there were areas of scarring, consistent with chronic pyelonephritis.The sister was not investigated by the authors but when aged 21 years she was said still to be suffering from hepatosplenomegaly. A barium meal had not shown oesophageal varices. Her kidneys were not palpable and her blood urea was 6.4 mmol/l. Intravenous pyelography had not been performed.Both the patient's parents were healthy into old age, and his children have been thoroughly investigated and appear free of renal or hepatic disease.
Case 2This 27-year-old man was found to have enlarged kidneys when he was 3 months old. Shortly afterwards he developed pyloric stenosis and Rammstedt's operation was performed. There followed surgery for craniostenosis at 18 months, at which time both his liver and spleen were palpable.Routine biochemistry revealed a blood urea of 11.2 mmol/l.He remained moderately well until the age of 14 years when he had a haematemesis from oesophageal varices. During surgery to construct a portocaval