What Does This Ultrasound Report For Upper Quadrant Pain Indicate?
Liver: Diffusely hyperechoic with course echotexture and difficult to penetrate consistent with hepatic steatosis. Cannot exclude developing cirrhosis. Small perihepatic ascites and probably right pleural effusion.
Spleen: enlarged measuring 14.1 cm suggesting underlying portal hypertension.
Gallbladder and pancreas were normal.
Can you provide some possibilities of what he could be dealing with? He has an appointment with GI department but not until October. I've been looking on the internet and can find descriptions of what some of it is, but what does it mean all together in less "technical" terms?
Thanks for any information you can provide.
fat build up in the liver, scarring of the liver, fluid
Detailed Answer:
HI, thanks for using healthcare magic
The changes initially mentioned are said to be consistent with hepatic steatosis (fatty liver disease).
This means that the increased echoes with ultrasound (diffuse hyperechoic ) and coarse/rough nature/structure (coarse echotexture).
Fatty liver disease refers to the build up of the fat in the liver. The fat build up can progress to inflammation of the liver and damage to the liver.
In some cases, it can go onto cirrhosis.
They cannot determine , based on the ultrasound, whether he is developing cirrhosis of the liver.
Cirrhosis refers scarring and formation of nodules/lumps in the liver due to the scarring.
Abnormal liver function or inflammation of the liver can cause the build up of fluid and this is likely the reason for the perihepatic ascites (fluid around an area near the liver) and would also contribute to the pleural effusion (fluid in a space in the chest cavity called the pleural cavity).
The blood from parts of the gastrointestinal tract ( part of the esophagus,stomach , intestine, spleen, pancreas, gallbladder) goes to the liver . The liver would then take out the nutrients, filter out the toxins and send the blood up the heart afterwards. The vein receives this blood and takes it to the liver is the PORTAL vein.
Portal hypertension is increased pressure in the portal vein. Because this vein is connect the the blood coming from the spleen, pressure in the portal vein can lead to enlargement of the spleen (the back up of pressure causes enlargement)
Portal hypertension is commonly caused by cirrhosis which was mentioned earlier though there are other causes as well.
Summary: (1) fatty liver disease (hepatic steatosis), possibly has cirrhosis (scarring and nodules ) in the liver
(2)small amount of fluid in the abdomen and fluid in the chest cavity
(3)possibly increased pressure in the portal vein (portal hypertension) which is causing an enlarged spleen
He would likely need more intricate imaging such as CT or MRI to determine the exact cause of these changes.
It is possible , if a reversible cause is found, that he may be treated and may improve
Treatment would depend somewhat on the cause.
I hope this helps, feel free to ask any other questions