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Is there anything wrong in UTRASOUND REPORT?

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I did an ultra sound test today. Attaching the report alongwith. CAn you tell me whats wrong with me? Is there anything to be scared about? Please do tell me the next step i need to take.

Thank you

Category: Internal Medicine Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at DoctorSpring.com
I understand your concern.
I have gone through your ultrasound report, and it shows mild hepatomegaly-liver enlargement, which can be secondary to fatty liver. Considering Indian diet, most people develop fatty liver by the time they cross 40 years old patientof age.
Do you have any history of alcohol consumption? If so, can you give me details regarding how much you used to drink. That also leads to fatty liver.
A good diet, rich in green leafy vegetables, limited protein, and non oily or fatty food, will stop the fatty liver from getting worse. If you keep your cholesterol under control and weight under control then there is nothing to worry about.
Do you have any symptoms as such? What is your height and weight currently? Also what is your BP?
What was the cholesterol value last time you got it checked?
Kindly reply as a follow up,

Patient replied :

Alcohol consumption - Avg 2 pegs/ day
But stopped drinking 3 months back as per doctors advice.
Height - 160 cms
Weight - 79 kgs
Blood Pressure - 130/80
Serum Cholesterol - 135 mg/dl (Normal : 130-210)
Serum Triglycerides - 140 mg/dl (Normal upto 170)
Serum HDL - 35 mg/dl (Normal 40-70)
Serum LDL - 72 md/dl (Normal 90-130)
Serum VLDL - 28 mg/dl (Normal 20-30)
Total Cholesterol/HDL Ratio - 3.8:1 (Normal 3.4-5)
LDL/HDL Ratio - 2:1 (Normal 1.1 - 3.6)
I would also like to know what they meant by -
1) Ill defined small hypo echoic focal lesions in the liver and
2) The simple cortical cyst seen in the kidney.
Are they something that I need to be worried about?
Do i need to do a CECT scan of abdomen? or would it get better by time?
Please do tell me the next step I need to follow to make myself better.

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Thank you for the follow up and additional details.
Since you have a history of alcohol consumption, and the fact that you're overweight explains your fatty liver. So with strict diet control and exercise, it can be altered and the liver function will get better in due time. In absence of any symptoms, the hypoechoic focal lesions can range from small areas of necrosis ( death of cellular tissue to small hemangiomas - localised collection of blood due to fatty liver ). Since you have a history of alcohol consumption, i will suggest you the CT Abdomen done, and it will be able to pick up the exact cause of the hypoechoic patches.
Also the renal cortical cyst needs no further intervention. It is found in most people over the age of 50 and is of benign etiology.
At the present moment you need to start following strict diet control with exercise.
Avoid oily or fatty foods.
Avoid too much salt in diet.
I will advise you start taking Tab. Liv 52 DS, once in emoty stomach in the morning and one at bed time for 3 months. This will reduce the fatty liver.
Also get a CECT Abdomen and upload the reports.

Patient replied :

I have done a CECT Scan of my abdoman. I am attaching the report alongwith. Please give me your opinion on the report and tell me what step I need to do next. Is there anything I should be worried about?

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Thank you for the follow up.
Your liver is mildly shrunken which again confirms the presence of fatty liver, but it is also showing early cirrhotic changes, which is secondary to fatty liver and alcohol consumption.
We need to follow you up and a repeat ultrasound will be needed after 6 months.
Meanwhile you need to give up alcohol completely and take Tab. Liv 52 DS as i mentioned. For you it is recommended that you take it twice a day 2 in empty stomach and 1 tablet at bed time ( 3 per day ). Also you need to get Syrup Silymarin 2 teaspoons at bed time everyday and continue it for 3 months. This will help in regenration of the liver cells, and once you finish the course, and abstain from alcohol completely, we can get another follow up ultrasound and take a decision from there.
STOP alcohol. Even one peg is not advisable.
The disease process can be stopped if you modify your lifestyle.

Patient replied :

Thanks for your opinion. Plus, I can also see that, in the report they have written that there are nodules on top of the liver. The chances are likely for neoplastic or regenerative nodules? Should i be concerned about that or its casual for cirrhosis?
And ya,I have completely stopped alcohol. Is there a change that I would be able to reverse the damage done to the liver?
The doctor whom I am consulting in person, have recommended me to use UdiLiv instead of Liv 52 DS. Do I need to make modifications to this? or should I add 2 tablespoons of Syrup Silymarin along with UdiLiv?

Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

The neoplastic or regenerative nodules, are secondary to cirrhosis.
The damage can't be reversed completely, but further damage can be prevented, and hence decompensated liver disease can be prevented.
You can take Udiliv definitely. It will also help in recovery of your liver.
And yes you should add silymarin, because it is a fairly new drug with pretty good results.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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