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What Does Fatty Infiltrations And Smooth Liver And Gallatones Indicate?

Posted on Tue, 29 Apr 2014

Question: was in hospital last week with abdominal pain i was took to a ward a told i have hepatitis i had a hep panel done and all viral heo come back negative. I think it was my ast level was 1555. I wastook for a ultrasound which showed fatty infiltrations and smooth liver and gallatones with no infection. I was discharged with gallstones and have a refferal for a gastro specialist. My enzyme level is now at 255. Can u shed XXXXXXX light on whats happening and what it could possibly be ? Going out of mind worrying about cirrhosis.

Answered by Dr. Deepak Kishore Kaltari (17 minutes later)

Brief Answer: Possibly hepatitis with co-inciental stone detecte Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear XXXX First and foremost let me reassure you, its definitely not Cirrhosis of Liver. I hope and assume that you have no habit of alcohol intake. Gall stones may sometimes slip into the common bile duct obstruction the outflow of bile in intestine. This causes elevation in Liver enzymes especially ALT and AST. There may or may not be elevation of Bilirubin. During this process there may be congestion of Liver causing fatty changes , also mild Hepatitis may show fatty Liver. I would like certain more clarification to come to conclusion for cause of elevated Liver enzyme. 1. Ultrasound : If the Ultrasound also revealed Common bile duct (CBD) was dilated , its likely that stone from gall bladder could have obstructed the CBD, causing fatty liver and elevated enzymes 2. If the CBD was of normal caliber during USG, its likely that Hepatitis is the cause of elevated Enzyme. During stage of Acute Hepatitis, Ultrasound picture may mimic that of fatty liver As there has been significant reduction in Enzyme level which is indeed a good sign. Its definitely not Cirrhosis, let me explain you why 1. Its very much unlikely to see a young lady of 26 years with Cirrhosis 2. There will be progressive rise in enzyme level and there will not be decline 3. Cirrhosis is end stage of Liver damage and in that case there will be derangement in liver Biochemistry profile including low Protein, Coagulation abnormality. It will defintely be picked up by scan. Kindly let me know the exact Ultrasound findings and other laboratory investigation. I would also to know the history with which you got admitted and sequence of events during stay in hospital. From the short description given till now, it appears to be Mild Hepatitis with co-incidental gall stones detected or Gall stones with CBD blocked due to stone. Will be happy to guide you further. Rest be assured its not Cirrhosis. Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCH Consultant Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (19 hours later)

below i have attached bloods taken on the second and fourth day i was alsounable to get the first set of bloods and ultrasound findings all i can tell you os what the doctor told me and that was smooth liver with fatty infiltrations and gallstones detected with no evidence of infection something called collectises oror something like that. my hospital stay i was told nothing i was put on two types anti biotics and a fluid drip as i was sick three days before admission. i was diagnosed with ggallstones three years ago but i nnever had any painpain after a year so they was left and the pain ztarted again 8 months ago on and off im a mum of two and mobidly obese. im terrified im not going to see see my kids grow up because of myliver . hope u can can help my anxiety . i only drink occassionally .

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer: There is no cause for concern Detailed Answer: Dear XXXX First and foremost let me reassure that there is absolutely no reason for worrying regarding your Liver, its not Cirrhosis. There is no evidence of infection, following are the points in favor of absence of infection 1. Total Leucocyte count is normal 2. Blood culture is negative 3. C-Reactive protein is negative Term used for presence of gall stones is Cholelithiasis, in majority of cases its asymptomatic . In your case you have developed symptoms which could possible be due to either gall stones or intake of alcohol. The only major abnormality present in your report is raised alanine transferase and slightly raised Alkaline phosphatase. Also on follow up there has been substantial decrease in alanine transferase. The fatty Liver in your case could be explained due to two factors 1. Morbid Obesity 2. Alcohol intake Both these factors by synergestic action cause fatty liver. Its definitely nothing to worry as its a reversible condition. Weight reduction and complete abstinence from alcohol is all that is required at these stage. Also if you develop abdominal pain and the symptoms are attributable to cholelithiasis in form of thickened gall bladder or Cholecystitis then Surgical removal of gall bladder is advisable. Presently all you need is relaxed mind, weight reduction and complete abstinence from alcohol. Take Care Best Regards Deepak

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Kishore Kaltari (21 minutes later)

what would have caused the hepatitis to that level though? would it be just simple fatty liver. ive read alot about XXXXXXX and im worried that i wont be here long if i have it. im sorry to ask so many questions but i suffer from anxiety im on tablets to control this atm. i only suffer anxiety when im left in limbo which u can see from my case i havent been told anything at this stage.

Answered by Dr. Deepak Kishore Kaltari (7 minutes later)

Brief Answer: Obesity and alcohol can elevate liver enzyme Detailed Answer: Hi Mild Liver dysfunction causing temporary elevation in Liver enzyme is quite often seen even after binge of alcohol consumptions. As Bilirubin, Serum Protein (these are synthesized by Liver) are normal there is absolutely no need to be concerned about. Mild Hepatitis is quite common in Morbid obese patient even after binge of alcohol. Internet is full of knowledge and resources, its always advisable to go by the advise of your doctors and experts, in case of any doubt you have all the rights to ask as many questions as possible. Do not worry, it was just a transient elevation of Liver enzyme. Take Care Best Regards Deepak

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Kishore Kaltari (7 minutes later)

thank you for helping me out i was at a lose as they refferd me to specialist i thought i must be seriously ill and dying. ive read so much stuff on line and none of them tell you when your obese that it can cause your liver to disfunction. ive lost two stone through stress the last two weeks most prob hasnt done my liver any favours as i can still mildly feel it hurting. is there any certain things i can do or eat that will help ?

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer: Obesity can cause fatty Liver Detailed Answer: Hi, Greetings. Morbid obesity definitely causes fatty Liver. If there is alcohol use it precipitates temporary dysfunction. There is definitely no cause to be worried about. Meet up your specialist, it will still be more reassuring. I would suggest you brisk walking 30 minutes at a stretch each day, also avoid oily food and consumption of fats especially saturated fats. Syrup Liv 52 will also be helpful 5 ml twice a day or Liv 52 capsules. Do write to me anytime you need any assistance. Take Care Best Regards Deepak

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Above answer was peer-reviewed by : Dr. Raju A.T