What Causes Increased Echogenicity With A Coarse Texture And Right Upper Quadrant Pain?

Posted on Mon, 14 Aug 2023

Question: I have had very elevated alkaline phosphatase, GGT and ALT blood levels for a few years now. Recently, I had a liver ultrasound done and I have increased echogenecity with coarse texture. I’m now having right upper quadrant pain. What does this all mean? What’s next? Should I be worried?

By the way, I don’t drink alcohol and I never have. I don’t have Diabetes or Hep A, B or C. I’m in excellent shape and I take care of my self. My common bile duct is dilated to 9 mm. I had my gallbladder removed over 2yrs ago.

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:

Obstructive pattern

Detailed Answer:

Hello,

The liver enzymes pattern is obstructive. MRCP/ ERCP is indicated with the dilated common bile duct to look for possible stone, stricture, tumors and/or obstruction.

Coarse echotexture indicates cirrhosis of the liver which can be due to non-alcoholic fatty liver disease or primary biliary cirrhosis. A liver biopsy can be advised for confirmation.

Prior to liver biopsy autoimmune hepatitis profile, primary biliary cirrhosis, alpha one antitrypsin deficiency, and XXXXXXX disease workup should be done in consultation with a gastroenterologist.

Hope I have answered your query.

Take care

Regards,
Dr Muhammad Sareer Khalil, General & Family Physician

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Above answer was peer-reviewed by : Dr. Raju A.T