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What Do These Ultrasound And Blood Reports Indicate?
Question: Hello Doctor,
Hope you are doing fine.
I took a repeat ultrasound last week and below are the results. I am a non-smoker and I occasional drinker(and had a couple of beers in the last 6 months). . My doctor is still worried about this non-alocoholic fatty condition. You answered my earlier question in October 2016 and I also shared the ultrasound and blood results then. The blood work shows a dip in my total cholestrol (from 219 to 192), LDL down from 143 to 122 and HDL also went down from 46 to 42 and triglycerides went down from 147 to 132. The liver size in my earlier ultrasound was 18 cm, it got down to 14.2 cm. I am trying to make life style adjustments in my eating habits and trying to be active at-least 3 to 4 days a week by walking/jogging for an hour.
Please let me know your thoughts, sir.
TECHNIQUE: Real time grayscale ultrasound evaluation of the
abdomen.
ABDOMINAL ULTRASOUND FINDINGS:
LIVER:
Size: 14.2 cm
Findings: Persistent mild and heterogeneously increased
parenchymal echogenicity suggestive of underlying fatty
infiltration. No focal space-occupying intrahepatic lesions
identified. No intrahepatic biliary dilation.
Main Portal Vein: 1.0 cm phasic flow, hepatopetal flow
GALLBLADDER:
Findings: Unremarkable
CBD measurement: 3 mm
PANCREAS:
Findings: Visualized segment is unremarkable. Partially obscured
by bowel gas
SPLEEN:
Size: 9.7 cm
Findings: Unremarkable
RIGHT KIDNEY:
Size: 10.3 cm
Findings: Unremarkable
LEFT KIDNEY:
Size: 10.7 cm
Findings: Unremarkable
AORTA: Unremarkable
IVC: Unremarkable
MISCELLANEOUS: No free fluid or pleural effusions.
Impression:
IMPRESSION:
1. Persistent mild hepatic steatosis without focal intrahepatic
lesions.
2. Otherwise, unremarkable abdominal ultrasound study.
Also, I repeated my blood work. Here are the results.
Total cholesterol 191 mg/dL <200 mg/dL
Triglyceride 134 mg/dL <150 mg/dL
HDL cholesterol 42 mg/dL >40 mg/dL
LDL Calculated 122 mg/dL <130 mg/dL
Cholesterol to HDL Ratio 4.5 <5.0
LDL:HDL Ratio 2.90 <3.51
VLDL (Calculated) 27 mg/dL <41 mg/dL
Hope you are doing fine.
I took a repeat ultrasound last week and below are the results. I am a non-smoker and I occasional drinker(and had a couple of beers in the last 6 months). . My doctor is still worried about this non-alocoholic fatty condition. You answered my earlier question in October 2016 and I also shared the ultrasound and blood results then. The blood work shows a dip in my total cholestrol (from 219 to 192), LDL down from 143 to 122 and HDL also went down from 46 to 42 and triglycerides went down from 147 to 132. The liver size in my earlier ultrasound was 18 cm, it got down to 14.2 cm. I am trying to make life style adjustments in my eating habits and trying to be active at-least 3 to 4 days a week by walking/jogging for an hour.
Please let me know your thoughts, sir.
TECHNIQUE: Real time grayscale ultrasound evaluation of the
abdomen.
ABDOMINAL ULTRASOUND FINDINGS:
LIVER:
Size: 14.2 cm
Findings: Persistent mild and heterogeneously increased
parenchymal echogenicity suggestive of underlying fatty
infiltration. No focal space-occupying intrahepatic lesions
identified. No intrahepatic biliary dilation.
Main Portal Vein: 1.0 cm phasic flow, hepatopetal flow
GALLBLADDER:
Findings: Unremarkable
CBD measurement: 3 mm
PANCREAS:
Findings: Visualized segment is unremarkable. Partially obscured
by bowel gas
SPLEEN:
Size: 9.7 cm
Findings: Unremarkable
RIGHT KIDNEY:
Size: 10.3 cm
Findings: Unremarkable
LEFT KIDNEY:
Size: 10.7 cm
Findings: Unremarkable
AORTA: Unremarkable
IVC: Unremarkable
MISCELLANEOUS: No free fluid or pleural effusions.
Impression:
IMPRESSION:
1. Persistent mild hepatic steatosis without focal intrahepatic
lesions.
2. Otherwise, unremarkable abdominal ultrasound study.
Also, I repeated my blood work. Here are the results.
Total cholesterol 191 mg/dL <200 mg/dL
Triglyceride 134 mg/dL <150 mg/dL
HDL cholesterol 42 mg/dL >40 mg/dL
LDL Calculated 122 mg/dL <130 mg/dL
Cholesterol to HDL Ratio 4.5 <5.0
LDL:HDL Ratio 2.90 <3.51
VLDL (Calculated) 27 mg/dL <41 mg/dL
Brief Answer:
Any symptoms?
Detailed Answer:
Hi.
Thanks for your review query.
Viewed the previous query and our discussions.
It is great to know that your lipid profile is within normal limits, liver has come back to normal size.
Your dietary control and regular exercises have helped you .
Since you are on a great path of recovery, there is less to worry about - rather not to worry about unless you have any symptoms and/or the blood work and other investigations show any problems.
Please let me know if you have any symptoms/complaints?
Continue with the diet control and regular exercises.
No alcohol or beer.
No fatty oily foods.
I hope this answer helps you, please give feedback and feel free to ask for further relevant queries if you feel that there is a gap of communication.
Any symptoms?
Detailed Answer:
Hi.
Thanks for your review query.
Viewed the previous query and our discussions.
It is great to know that your lipid profile is within normal limits, liver has come back to normal size.
Your dietary control and regular exercises have helped you .
Since you are on a great path of recovery, there is less to worry about - rather not to worry about unless you have any symptoms and/or the blood work and other investigations show any problems.
Please let me know if you have any symptoms/complaints?
Continue with the diet control and regular exercises.
No alcohol or beer.
No fatty oily foods.
I hope this answer helps you, please give feedback and feel free to ask for further relevant queries if you feel that there is a gap of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
I went 2 weeks before with an upper abdominal pain both on the right and left. I forgot to send you a xray of my upper GI that I also had along with abdomen ultrasound. I am taking Famotidine 40 mg to treat my acid reflux. You can see the xray results below.
I feel a lot better now. I was worried when my doctor told me that the fatty liver is still an issue for me and it could progress to liver cirrhosis or liver cancer if proper steps are not taken to reverse it. My doctor said that there is no improvement in the ultrasound results from the one taken earlier. He also said that for my age the he wants to seemy LDL under 90 and improve my HDL to at least 50. I am worried why doctor was so concerned even though the blood work showed a marked improvement? I am also concerned if the doctor is suspecting anything serious and if it is wouldn't it show up in my lipid profiles or the abdomen ultrasound? Please provide your thoughts and address my concerns.
Here are the results for upper GI.
XR UPPER GI With AIR CONTR With/O KUB
CLINICAL INDICATION: abdominal pain.
TECHNIQUE: Double contrast upper GI study was performed at 0820
hours.
FINDINGS: The esophagus demonstrates normal mucosal pattern with
no focal ulcerations, mass lesions, or strictures. Extensive
gastroesophageal reflux is noted to the UES. Small hiatal hernia
is noted. Esophageal motility is within normal limits.
The stomach demonstrates normal rugal fold pattern. No masses,
strictures, or ulcerations are seen. Pylorus and duodenal bulb
are normal in appearance.
Sweeping loop of the duodenum demonstrates normal mucosal
pattern. Ligament of Treitz is in its normal anatomic location.
A total of 3 minutes of fluoroscopy time was recorded.
Patient tolerated the procedure well and left the suite in stable
condition.
Impression:
IMPRESSION:
1. Extensive GERD to the UES.
2. Small hiatal hernia.
I went 2 weeks before with an upper abdominal pain both on the right and left. I forgot to send you a xray of my upper GI that I also had along with abdomen ultrasound. I am taking Famotidine 40 mg to treat my acid reflux. You can see the xray results below.
I feel a lot better now. I was worried when my doctor told me that the fatty liver is still an issue for me and it could progress to liver cirrhosis or liver cancer if proper steps are not taken to reverse it. My doctor said that there is no improvement in the ultrasound results from the one taken earlier. He also said that for my age the he wants to seemy LDL under 90 and improve my HDL to at least 50. I am worried why doctor was so concerned even though the blood work showed a marked improvement? I am also concerned if the doctor is suspecting anything serious and if it is wouldn't it show up in my lipid profiles or the abdomen ultrasound? Please provide your thoughts and address my concerns.
Here are the results for upper GI.
XR UPPER GI With AIR CONTR With/O KUB
CLINICAL INDICATION: abdominal pain.
TECHNIQUE: Double contrast upper GI study was performed at 0820
hours.
FINDINGS: The esophagus demonstrates normal mucosal pattern with
no focal ulcerations, mass lesions, or strictures. Extensive
gastroesophageal reflux is noted to the UES. Small hiatal hernia
is noted. Esophageal motility is within normal limits.
The stomach demonstrates normal rugal fold pattern. No masses,
strictures, or ulcerations are seen. Pylorus and duodenal bulb
are normal in appearance.
Sweeping loop of the duodenum demonstrates normal mucosal
pattern. Ligament of Treitz is in its normal anatomic location.
A total of 3 minutes of fluoroscopy time was recorded.
Patient tolerated the procedure well and left the suite in stable
condition.
Impression:
IMPRESSION:
1. Extensive GERD to the UES.
2. Small hiatal hernia.
Brief Answer:
as explained in details.
Detailed Answer:
Fatty liver may cause the concerns as your Doctor has mentioned and that you are getting the things under control well.
Continuation of the management that you are undertaking so well will help you properly; the liver size has reverted back to normal so why to worry about so much.
Getting LDL down and HDL up may help further and I am sure you will achieve this.
GERD is a problem that can cause you symptoms.
Continue Famotidine.
Request your Doctor to add on motility regulator like Domperidone.
Take antacids when on empty stomach.
Small frequent feeds.
Stress and anxiety control helps a lot.
Adequate sleep.
Small hiatal hernia are not usually causing any symptoms.
Pain on both sides of abdomen can be due to colitis or IBS that is irritable bowel syndrome.
When there is so much improvement, one should not worry at the moment.
There is no suspicion about cancer or cirrhosis, that is the possible complication and that too occurs very rarely.
You can have fibroscan of the liver if the facility is there.
as explained in details.
Detailed Answer:
Fatty liver may cause the concerns as your Doctor has mentioned and that you are getting the things under control well.
Continuation of the management that you are undertaking so well will help you properly; the liver size has reverted back to normal so why to worry about so much.
Getting LDL down and HDL up may help further and I am sure you will achieve this.
GERD is a problem that can cause you symptoms.
Continue Famotidine.
Request your Doctor to add on motility regulator like Domperidone.
Take antacids when on empty stomach.
Small frequent feeds.
Stress and anxiety control helps a lot.
Adequate sleep.
Small hiatal hernia are not usually causing any symptoms.
Pain on both sides of abdomen can be due to colitis or IBS that is irritable bowel syndrome.
When there is so much improvement, one should not worry at the moment.
There is no suspicion about cancer or cirrhosis, that is the possible complication and that too occurs very rarely.
You can have fibroscan of the liver if the facility is there.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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