LIVER?

[BRANDIS24]

I HAVE BEEN HAVING PAIN IN MY UPPER RIGHT SIDE FOR ABOUT THREE YEARS. I WENT TO A FAMILY DOCTOR ABOUT THE TIME IT STARTED AND THEY SENT ME TO HAVE CTS. IWAS ADMITTED TO THE HOSPITAL FOR IV ANTIBIOTIC TREATMENT FOR SUSPECTED CROHNS DISEASE. THEY SAID THAT WASN'T IT BUT THAT I HAD A SPOT ON MY LIVER, I HAVE HAD FOUR MORE CTS ONE ULTRASOUND AND A TEST FOR MY GALLBLADDER BUT I STILL DONT KNOW WHAT IS WRONG WITH ME. THE SPOT HAS GOTTEN BIGGER BUT MY SCANS SAY THE THOUGHT OF A NEOPLASMA IS NOT LIKELY IN MY AGE. BUT CANNOT BE RULED OUT. IM 25 W FEMALE BUT CAN NOT BE RULED OUT. SOMETIMES MY TBIL AND MY IRON IS ELEVATED AT TIMES BUT I CANT SEEM TO GET AN ANSWER. I ALSO HAVE HAD A FEVER AND NAUSEA ALSO I AM ALWAYS EXHAUSTED.

[Kevin Pho, MD]

I agree with the workup thus far.  If the CT scan is inconclusive, further imaging can be done with an MRI.  Any suspicious lesions can be considered for possible biopsy for a more conclusive diagnosis.  

The biliary tree can be evaluated with an MRCP or ERCP.  If an ERCP is considered, the Sphincter of Oddi can be evaluated for dysfunction - which can also lead to RUQ discomfort.  

If the liver enzymes are rising, obtaining a liver biopsy can be considered to exclude intrinsic liver disease.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[BRANDIS24]

WHAT I WAS TRYING TO SAY IS, IWENT TO THE DOCTOR WITH A FEVER AND UPPER RIGHT QUADRANT PAIN. I HAVE HAD BLOOD TEST THAT ALL THE SHOW IS THAT MY TBIL AND IRN LEVELS ARE ELEVATED. THERE HAS BEEN BILIRUBIN AND URIBILIGENS IN MY URINE, I HAVE HAD 4 CAT SCANS AN ULTRASOUND AND A HIDASCAN, THE CATSCAN CANNOT RULE OUT A NEOPLASMA OR BLOCKED BILE DUCT. THE LAST SCAN SAID THAT IT LOOKS MOST CONSITANT WITH FATTY, NOT 100% IT IS IN THE LEFT HEPATIC LOBE. ALSO I HAVE HAD A COLONSCOPY?? SHOWED NOTHING. I HAVE HAD HEP PANELS ALL NEGATIVE. THERE IS A NEW PAIN NOW THAT IS MORE TO MY LEFT SIDE INTO MY BACK BUT THIS IS SEPERATE FOM MY OTHER PAIN AND STARTED IN THE LAST YEAR.  THE ORIGINAL PAIN IS ON AND OFF FROM MODERATE TO VERY SEVERE RIHGT UNDER MY RIB TO THE INSIDE LEFT