upper right quadrant abdomen - liver

Question

I had done two sonography of the Abdomen and pelvis (three months back and today) and the impressions/ results are : 1)Old report (Three months back): Fatty Liver - The liver is bright s/o Fatty liver. It is normal size and outline.Two ill defined hypodense lesions are seen in the gallbladder fossa. These are of illdefined etiology ??? Focal fatty sparing. 2) Latest reports (todays) : The liver is normal in size, shape and shows a changes of fatty infiltration. This may be clinically co-related. My LFTs are normal. HIV (I & II) - Elisa Negative Anti Hepatitis C Virus - Total (AHCV) Negative Hepatitis B Surface Antigen (HBsAg) Negative

How serious is the condition. Does it mean cirohsis, liver disease, cancer etc What are the precautions to be taken. Whats medication, treatment or further tests to be done.

Answer

It sounds from the two ultrasounds that the bright signal is consistent with fatty liver - or "steatosis". Fat by itself is not necessarily harmful; however fat with inflammation can be harmful and lead to scarring and even cirrhosis. This type of liver disease is referred to as NASH - non-alcoholic steatohepatitis.

The risk factors for fatty liver are diabetes, high triglycerides, high cholesterol, and obesity.

You may want to talk to a liver specialist about getting a liver biopsy to see if you have plain fatty liver or inflammed fatty liver or "steatohepatitis".

Dr. McGovern