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Ascites Detected In USG. Chronic Liver Disease, Thickened Gall Bladder Due To Ascites, Spleenomegaly. Permanent Liver Damage?
Doctor,
My husband who is 37 years of age was suffering from gross Ascites as detected in the USG on 12th April 2013. The impression was: coarse echotexture with increase echogenecity of liver – due to chronic liver disease; Dilated portal vein to rule out portal hypertention, Thickened gall bladder wall-due to ascites; Splenomegaly; Gross Ascites.
He is under medication now with salt restricted diet, large intake of fruits & vegetable. The current medications are Aldactone 100mg-1tab per day, Levolexin tab -1 tab twice daily , Betonin syrup 2 spoon twice daily & Liv 52 DS 1 tab twice daily.
On 4th May 13 he underwent the following test with the following result.
Upper G.I. Endoscopy for esophageal varices : Result: OESOPHAGUS:-grade IIX5 esophageal varices seen. Mucosa is smooth & pink with no ulcer or erosion. No structure, polyp, or tumor seen. Gastro-esophageal junction is located at 37 cm from incisor teeth. No evidence of hiatus hernia. STOMACH:-fundus body & antrum examined. Portal congestive gastropathy noted in fundus. No food residue, foreign body or blood seen. Fold thickness is normal in fundus & body. There is no suggestion of gastric varix. Stomach shows no polyp or tumor. Pylorus is central & shows no edema or scarring. DUODENUM:- first D1 & second D2 examined. No blood in the lumen. There is no suggestion of ulcers, erosions, diverticulum or duodenal scarring. No nodularity , tumor or polyp seen. Mucosal folds in D2 are normal at endoscopy. IMPRESSION: esophageal varices Portal Congestive Gastropathy.
Liver Function Test: Result: TOTAL BILIRUBIN -1.86, DIRECT BILIRUBIN-0.79, INDIRECT BILIRUBIN-1.07, TOTAL PROTEIN-8.2, ALBUMIN-4.2, GLOBULIN-4.0, A/G RATION-1.0, SGOT (AST)-79, SGPT (ALT)-59, ALKALINE PHOSPHATASE-245, SGGT-307.
ANTI HCV ELISA – Not detected
HBs Ag (ELISA) – Reactive
Now, the Doctor advised him to remain on the same medication as mentioned above & to undergo LFT after 3 weeks.
Please advice is it a permanent liver damage? How much is his liver affected? What is the recovery time. Please help me.
My husband who is 37 years of age was suffering from gross Ascites as detected in the USG on 12th April 2013. The impression was: coarse echotexture with increase echogenecity of liver – due to chronic liver disease; Dilated portal vein to rule out portal hypertention, Thickened gall bladder wall-due to ascites; Splenomegaly; Gross Ascites.
He is under medication now with salt restricted diet, large intake of fruits & vegetable. The current medications are Aldactone 100mg-1tab per day, Levolexin tab -1 tab twice daily , Betonin syrup 2 spoon twice daily & Liv 52 DS 1 tab twice daily.
On 4th May 13 he underwent the following test with the following result.
Upper G.I. Endoscopy for esophageal varices : Result: OESOPHAGUS:-grade IIX5 esophageal varices seen. Mucosa is smooth & pink with no ulcer or erosion. No structure, polyp, or tumor seen. Gastro-esophageal junction is located at 37 cm from incisor teeth. No evidence of hiatus hernia. STOMACH:-fundus body & antrum examined. Portal congestive gastropathy noted in fundus. No food residue, foreign body or blood seen. Fold thickness is normal in fundus & body. There is no suggestion of gastric varix. Stomach shows no polyp or tumor. Pylorus is central & shows no edema or scarring. DUODENUM:- first D1 & second D2 examined. No blood in the lumen. There is no suggestion of ulcers, erosions, diverticulum or duodenal scarring. No nodularity , tumor or polyp seen. Mucosal folds in D2 are normal at endoscopy. IMPRESSION: esophageal varices Portal Congestive Gastropathy.
Liver Function Test: Result: TOTAL BILIRUBIN -1.86, DIRECT BILIRUBIN-0.79, INDIRECT BILIRUBIN-1.07, TOTAL PROTEIN-8.2, ALBUMIN-4.2, GLOBULIN-4.0, A/G RATION-1.0, SGOT (AST)-79, SGPT (ALT)-59, ALKALINE PHOSPHATASE-245, SGGT-307.
ANTI HCV ELISA – Not detected
HBs Ag (ELISA) – Reactive
Now, the Doctor advised him to remain on the same medication as mentioned above & to undergo LFT after 3 weeks.
Please advice is it a permanent liver damage? How much is his liver affected? What is the recovery time. Please help me.
posted on
Fri, 10 May 2013
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 18 May 2013
Answered on
Mon, 20 May 2013
Last reviewed on
Hi,
Welcome to HCM,
After going through the history, he has Chronic hepatitis due to viral Hepatitis and causing portal hypertension.
Liver functions are deranged and there are esophageal varices formation which id due to portal hypertension.
He has lot of ascites and treatment is according to his disease there is significant liver damage but everything is not lost so please consult a good Gastroenterologist to take appropriate therapy. If there is bleeding there is sclerotherapy.
There are treatment to reduce portal pressure medical and as well as surgical endoscopic intervention like TIPS(Transjugular intrahepatic portosystemic shunt).
He needs to take proper care and follow up to monitor the status and any deterioration in the health.
Please take care.
Good Luck.
Dr.Akhilesh Dubey M.D.
Welcome to HCM,
After going through the history, he has Chronic hepatitis due to viral Hepatitis and causing portal hypertension.
Liver functions are deranged and there are esophageal varices formation which id due to portal hypertension.
He has lot of ascites and treatment is according to his disease there is significant liver damage but everything is not lost so please consult a good Gastroenterologist to take appropriate therapy. If there is bleeding there is sclerotherapy.
There are treatment to reduce portal pressure medical and as well as surgical endoscopic intervention like TIPS(Transjugular intrahepatic portosystemic shunt).
He needs to take proper care and follow up to monitor the status and any deterioration in the health.
Please take care.
Good Luck.
Dr.Akhilesh Dubey M.D.
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