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DR. EHTISHAM
DR. EHTISHAM, Doctor
Category: Medical
Satisfied Customers: 6046
Experience:  MBBS, FCPS
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I've just had some abdominal ultrasound results back and

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Hi there, I've just had some abdominal ultrasound results back and would like a bit more clarity on the potential outcomes as my doctor was very vague.
JA: The Doctor can help. Just a couple quick questions before I transfer you. Have you been using any medication since the ultrasound? How severe are any complications?
Customer: 33/Female. I just got some results from an abdominal and renal ultrasound and the doctor printed off the findings. She has recommended gallbladder removal and has said she’ll call a radiologist tomorrow to ask whether I need an MRI on the liver.Liver: “There are several large hypoechoic focal lesions within the liver. The largest is within the left lobe measuring 27x20x25mm which demonstrates some internal vascularity with Doppler. Suggest consultant radiologist opinion whether cross-sectional imaging may be beneficial in assessing these areas further. The liver parenchyma is hyperechoic in echotexture, consistent with fatty infiltration. No dilated intrahepatic ducts. The portal vein is patent with normal hepatopetal flow”Gallbladder: “There are several calculus of approx 6mm within the thin walled gallbladder. Normal calibration common duct”
JA: What did you discuss at your last visit to the doctor?
Customer: I had some blood tests done back in October which I can upload the results for. I am also very deficient in Vitamin D and folate which I'm currently taking supplements for. Feel very tired all the time, upper right quadrant pain, aching legs, periods of my heart feelings like it's beating really fast and all over my body at times. A lot of this I assumed was from the Vitamin D deficiency but now wondering if it's related to the liver issue. Also Blood in urine.
JA: Anything else in your medical history you think the Doctor should know?
Customer: Recently had a chest X-Ray which was okay, an 24hour ECG and echocardiogram back in January which was also fine. All other organs on the ultrasound seemed okay, just issues with liver and gallbladder. Doctor has suggested removal of gallbladder.

Hello! My name is Dr.Ehtisham. Welcome to JustAnswer. I'm reviewing your question now, and will post back with your reply momentarily.

Are you on any hormone therapy?

Regards

Customer: replied 9 days ago.
No, none. Please find attached a copy of the bloodwork I had done back in September
Customer: replied 9 days ago.
Only medication I take is supplements for the deficiencies - I was prescribed 20,000ui of Vitamin D twice per week to correct deficiency - I took these for 6 weeks but they made me feel terrible so I've now dropped down to 800ui per day. Also 5mg Folate and 200mg Magnesium. It's strange I am deficient in folate as I think I get a lot of it in my diet - maybe the liver issues could be causing malabsorption?
Customer: replied 9 days ago.
If you could explain the liver ultrasound reading in layman's terms it'd be hugely appreciated. I know it's really hard to tell until I've had more diagnostic imaging done, but in conjunction with the blood tests I attached earlier, is it possible to get a sense of anything?

Thanks for the details

There is no doubt that you have gallstones and will need a gall bladder removal

But the concerning thing is the presence of multiple focal lesions in liver

They can be benign like adenoma or even a cancer

This do need further evaluation by a CT scan

That would be my recommendation as ultrasound will not be of much help to define the details of these lesion

Please do let me know if you have any other question

Regards

Customer: replied 9 days ago.
The doctor is going to speak with the radiologist to arrange more imaging, but I was wondering if you could give any more information about the likelihood of cancer given the blood tests I attached to my earlier message and the size/description in the ultrasound report? I know there are both benign and malignant lesions, but do my blood tests suggest cirrosis or liver damage?

No there is no evidence of Cirrhosis

But tumor can develop in non-cirrhotic liver too

And some time it can be a metastasis from other site like breast or ovary

Your other lab values like hemoglobin and inflammatory markers are normal so this is a good sign but obviously you can not leave it as such and should have a CT scan

Please do let me know if you have any other question

Regards

Are you with me?

Anything else you need help with?

Regards

Customer: replied 9 days ago.
No thank you. I don't really know what else to ask, I just wanted a bit of clarity.

You are welcome

I think CT scan will answer a lot of questions

If done please leave a 5-stars rating to give me credit for my service

Regards

 

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