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Gastroenterology (Expert Forum)
Enlarged Spleen after Ultra Sound
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Enlarged Spleen after Ultra Sound
by TJ12345, Mar 09, 2005 12:00AM
Recent visits with Gastroenterologist for stomach discomfort and evaluation of elevated Liver Function tests. Have had mildly elevated LFT and high Cholesterol for 6 years, which Primary Physician attributed to fatty liver.
Info:
29 year old Male, 6'4 255pds
Cholesterol range (250 - 220)
ALT (50 -90)
AST (30 45)
Total Bilirubin (1.6 - 1.8) Direct Bilirubin (Normal)
** One unique thing I noticed was that during exercise and diet ALT & AST levels return close or too normal but Total Bilirubin stayed elevated.
Gastroenterologist ordered abdominal ultra sound and HIDA Scam with EF.
Results:
Hida-scan ejection 3% no stones visible
Ultra sound showed enlarged spleen.
Gastroenterologist has now ordered abdominal CAT scan, and also scheduled meeting with general surgeon for removal of gallbladder. Also planning to do a Liver biopsy with gallbladder surgery.
Can the enlarged spleen be related to dysfunctional gallbladder or fatty Liver? Also is my Gastroenterologist taking all the correct steps? Will a CAT scan help determine cause of enlarged spleen? At what point should I have additional blood work done.
Thanks for the help.
Info:
29 year old Male, 6'4 255pds
Cholesterol range (250 - 220)
ALT (50 -90)
AST (30 45)
Total Bilirubin (1.6 - 1.8) Direct Bilirubin (Normal)
** One unique thing I noticed was that during exercise and diet ALT & AST levels return close or too normal but Total Bilirubin stayed elevated.
Gastroenterologist ordered abdominal ultra sound and HIDA Scam with EF.
Results:
Hida-scan ejection 3% no stones visible
Ultra sound showed enlarged spleen.
Gastroenterologist has now ordered abdominal CAT scan, and also scheduled meeting with general surgeon for removal of gallbladder. Also planning to do a Liver biopsy with gallbladder surgery.
Can the enlarged spleen be related to dysfunctional gallbladder or fatty Liver? Also is my Gastroenterologist taking all the correct steps? Will a CAT scan help determine cause of enlarged spleen? At what point should I have additional blood work done.
Thanks for the help.
Doctor's Answer
by Kevin Pho, MD, Mar 09, 2005 12:00AM
, Mar 09, 2005 12:00AM
The liver showing a low ejection fraction may be responsible for your pain. In the abscence of other causes, removing the gallbladder is not an unreasonable option.
There can be many causes for an enlarged spleen. This can include infections, end stage liver disease (i.e. cirrhosis), various types of anemias, cancers and sarcoidosis are all possible.
If the liver disease is advanced, it is possible that it may be related to the enlarged spleen. The CT scan may be helpful in further elucidating the cause.
As for further blood tests, a blood count to evaluate for anemia or other possible blood disorders should be considered.
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 patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
There can be many causes for an enlarged spleen. This can include infections, end stage liver disease (i.e. cirrhosis), various types of anemias, cancers and sarcoidosis are all possible.
If the liver disease is advanced, it is possible that it may be related to the enlarged spleen. The CT scan may be helpful in further elucidating the cause.
As for further blood tests, a blood count to evaluate for anemia or other possible blood disorders should be considered.
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 patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Member Comments
by veronicas24, Mar 22, 2005 12:00AM
i had an enlarged spleen and i have TTP so you need to have more blood work done to make sure you don't have it
