LIVER AND PANCREAS FATTY INFILITRATION - WHAT DOES THIS MEAN?

[anc]

I AM 39 YRS OLD, OVERWEIGHT, AND I AM 5 MONTHS POSTPARTUM AND BREASTFEEDING MY 3RD CHILD.  MEDICAL HISTORY; MIDLY ASTHMATIC WITH NO USE OF ASTHMA MEDS IN THE LAST 9 MONTHS, HYPOTHYROID AND TAKING SYNTHROID. FAMILY STRONG MEDICAL HISTORY OF DIABETES.

A ROUTINE BLOOD TEST FOUND ALL NORMAL VALUES EXCEPT MIDLY ELEVATED AST 37(NORMAL 14-36), AND ALT 56 (NORMAL 9-52).  TRIGLICERIDES (triglycerides) 128, CHOLESTEROL 203, HDL 53L, LDL 124.  GLUCOSE 108 (NORMAL UP TO 105).   ULTRASOUND REPORT:  LIVER PARENCHYMA IS INCREASED DIFFUSELY IN REFLECTIVITY AND ATTENUATION.  PARENCHYMA IS SLIGHTLY COARSE AND, THERE ARE NO FOCAL LESIONS.  PATTERN SUGGESTS PRIMARILY DIFFUSE FATT INFILTRATION WITH, PERHAPS, A MINIMAL COMPONENT OF FIBROSIS.  SPLEEN IS NOT ENLARGED, THERE ARE GRANULOMATOUS SPLENIC CALCIFICATIONS.  GALL BLADDER VOLUME AND WALL THICKNESS ARE NORMAL, NO STONES.  PANCREAS IS FAT INFILTRATED, NORMAL IN SIZE AND SHAPE.  BOTH KIDNEYS APPEAR NORMAL.  NO PREVERTEBRAL ADENOPATHY.  AORTA IS UPPER NORMAL IN CALIBER AS 12MM. THERE MAY BE SOME VERY NIMINAL AREAS OF SUB INTIMAL THICKENING, THERE ARE NO DISCRETE PLAQUES.  

WHAT DOES THIS MEAN REGARDING LIVER, PANCREAS?  COULD THIS ULTRASOUND RULE OUT CANCER, OR WHAT IS IT?  WHAT SHOULD BE DONE NEXT, HOW CAN I TREAT THIS? THANK YOU

[Kevin Pho, MD]

The ultrasound does not suggest cancer in the liver or gallbladder.  An ultrasound is not the ideal modality to image the pancreas.  If pancreatic cancer is a concern, a CT would be a better test.

Fatty infiltration can be caused by alcohol use as well as what's called non-alcoholic steatohepatitis.  The former cause can be treated by abstaining from alcohol.  The latter cause can be helped by weight loss, exercise, and lifestyle changes.  As long as the liver function tests remain stable, there is no specific medication indicated for fatty liver.  

These options can be discussed with your personal physician.

Followup with your 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.
kevinmd_

[Ambaine]

I am finding this forum an interesting avenue to share issues related to liver and pancreas. I have been having epigastric pains in  the upper part of the abdomen and a USS was performed. My liver was found to be of moderate size 9149mm in MCL) shape and homogenously hyperechogenic (of fatty-fibrotic pattern) with noral gall bladder and bile ducts. The Pancreas is of moderate size (28x18x22mm) and heterogeneously hyperechogenic. The Pancreatic dusct is normal. The Consultant Radiologist mentioned in his report that the features were suggestive of chronic hepatitis and pancreatitis. He also said that the fatty infiltration of the liver and pancreas are differentials.

I am overweight (106kgs) and my doctor has said I need to go on a nutritious low fat diet and do alot of exercises. I hope this will be able to do the magic as I am worried especially with the Pancreatitis. The pains are still there but administration of a gastric anti-acid relieves them.