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Report of MDCT SCAN OF HBS and want to know the patient real status

I am re posting this question here because of the forum relevance.

Lat week my father did CT SCAN and I am describing here the findings and impression.

Clinical Information: CLD

Age: 63 Y

Blod group: O negative

Findings:

Liver: The liver is enlarged in size with slight irregular borders. The internal structure and attenuation are within normal limit. No focal abnormalities are noted. Vascular structures are normal.No abnormal enhancement is seen.

Biliary Ducts: The intrahepatic and extrahepatic billary ducts are normal in their course, width and contents.

Gall Bladder: The gall bladder is normal in size with smooth margins. No intraluminal hyperdensities are noted.

Pancreas: The pancreas presents normal size(proportion to age) with normal parenchymal structure and attenuation values. No focal intrapancreatic changes seen. The pancreatic ducts is not dilated.

Spleen: The spleen is enlarged in size with no focal lesion.

Kidneys: Both the kidneys are in normal in size, shape, position, outline and density.

Mild ascites is noted. No para aortic lymphadenopathy is seen.
Abdominal vascular structures appear normal.
The imaged bowel and other abdomnal organs show no gross abnormality.


Impression:
1. CT findings of HBS are suggestive of CLD without evidence of liver SOL.
2. Hepatosplenomegaly.
3. Mild ascites


My question:
==========
1. I need to know actually how serious the patient's liver condition is? My patient is now at home, taking rest, taking medicine as prescribed by doctor.

2. Can the patient be normal by taking medicine, rest and following diet roles?

3. Does the finding suggest a liver transplantation?

4.He was suffering from jaundice from last 2 months but now he has almost recovered from jaundice.Now he is almost normal condition. We had to give 4-5 bag blood over the last 2 weeks.

Please let me know if you need more information.

Looking forward your kind reply.
4 Responses
446474 tn?1446347682
COMMUNITY LEADER
A high bilirubin is what causes the eyes and skin to turn  yellow.
"Bilirubin is made in the body when old red blood cells are broken down. The breakdown of old cells is a normal, healthy process. After circulating in your blood, bilirubin then travels to your liver. In the liver, bilirubin is excreted into the bile duct and stored in your gall bladder. Eventually, the bilirubin is released the small intestine as bile to help digest fats and ultimately excreted with your stool."

1. Patient does not have the possibility of cancer. He did not tell me from where the jaundice came and I did not ask the question because I do have very less knowledge regarding this. I myself checked all the report and saw no hepatitis related disease exists. Also doctor did not tell me anything such.
Yes, no cancers were seen on the CT scan. Sometimes a growing tumor can block the flow of bile which contains the bilirubin.



1. I am now exactly sure what is the condition of my father. Actually here Doctor used to speak very less and it is also a bit frightening to ask more questions from them.
I'm sorry I don't know the cultural norms in Bangladesh.

2. After proving CT Scan report to you guys I was expecting whether you could tell me actually how much danger the condition of my father liver is or any advice/suggestion what I can do further for my father. Actually here it is not possible to depend on Doctor 100% because they have too much patient and other activities.

"2. Patient condition is not that much bad.
3.  Though he has advanced liver cirrhosis but still it is not major."

You say your father has cirrhosis but that it is not too bad. Cirrhosis is always a serious condition. It is the last stage of liver disease. Anyone with cirrhosis must never drink again. Alcohol is toxic to the liver and will make his liver disease worse and can be life-threatening. Without the option of a liver transplant it can lead to a very terrible death I am sorry to say. Also cirrhosis can lead to liver cancer which is fatal if a person doesn't get a liver transplant. My life was saved by having a liver transplant for my liver cancer 7 weeks ago.

3. Is there any possibility that my father might attack by jaundice again if liver does not improve much?
Yes, If his jaundice was caused by his liver disease if his liver disease gets worse at some point he may have jaundice again. Unfortunately there are many other terrible complications from advanced liver disease as well that appear then the liver starts to fail.

"5.He advised to take right amount of protein, carbohydrate and only 1.5 liters water daily and no Oily/fatty food.  Also he is taking much rest at home. "
A healthy diet is important. Protein makes muscles. Many people with cirrhosis can lose their muscles when the disease is advanced.  
He should rest now. But it is good to stay as active as one can because if someone rests too much they get weaker over time.
Walking is the best exercise for anyone with cirrhosis.

"6. Doctor advised me to meet after 1 month for follow up treatment."
Good. I hope your father is much better by then.

7. Now my father skin color become to normal from yellow also he become a bit strong."  
Very good. I hope this was only a temporary issue but as I said it may come back at some time so be sure that your father knows to go to the hospital if his eyes start turning yellow. The eyes are easier to see the color change before noticing the skin change.
---------------------------------------------------------------------------------------
Here is a good overview of Cirrhosis in English....
"CIRRHOSIS: advanced liver disease "
http://www.natap.org/2002/Oct/103002_2.htm

...SIGNS AND SYMPTOMS:

* Your doctor may ask you about alcohol abuse, hepatitis, poisonous exposures, blood transfusions, or IV drug abuse.

* You may complain of nausea, weight loss or gain, fluid overload, feeling weak and tired, and loss of sex drive.

*  Your skin and eyes may turn yellow (a condition called jaundice).

* You might have fever, abdominal swelling or pain, difficulty breathing, vomiting, diarrhea, bleeding from gums or nose, blood in your vomit or feces, and abnormal menstrual periods.

* Other symptoms include loss of muscle mass, ankle swelling, confusion (hepatic encephalopathy), and hemorrhoids. Men might notice enlargement of the breasts (gynecomastia), scrotal swelling, or small testes.

HOME CARE:

You must stop drinking alcohol. If you stop all alcohol intake, you may slow the disease and feel better.

Ask your doctor what medications you should avoid that may be harmful to your liver.

Begin a low-sodium diet if you are having problems with fluid retention.

Eat a balanced diet with adequate calories and protein. You also may want to take a daily multivitamin if your doctor agrees.

If you ever have developed any brain disorder caused by your liver (hepatic encephalopathy), you should decrease your protein intake.

WHEN TO CALL THE DOCTOR;

Sudden weight changes

Increasing water retention

Yellow skin (jaundice)

WHEN TO GO TO THE HOSPITAL:

Blood in your vomit or stool

Difficulty breathing

Abdominal pain

Confusion or bizarre behavior

Repeated vomiting

Fever
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I am sorry it is very difficult to determine exactly how bad your father's liver disease is and what caused the jaundice.

Sincerely,
Hector
446474 tn?1446347682
COMMUNITY LEADER
I am afraid the information you provide is too little to determine what the status of your father's liver disease is or what caused the jaundice he experienced. One test can not determine the status of a person's liver disease. The only way to know the status of your fathers disease and what was the cause of the jaundice, assuming the doctor has come to a conclusion, is to ask him/her. A CT scan is not a diagnosis. It is one test of many that is used to come to a diagnosis.

CLD mean Chronic Liver Disease
SOL mean Space Occupying Lesion
Hepatosplenomegaly is a condition in which both the liver and spleen are enlarged.

The doctor appears to be trying to understand what was the cause of your father's jaundice. It appears that the doctor thought that there might have been something causing a blockage of bile. Which is why they are looking for lesions (some type of growth that could obstruct the bile, ie a begin lesion or cancerous one). That is why the conclusion mentions SOL which means Space Occupying Lesion. Note that no lesions were found anywhere in his abdomen which is good.

What conclusion have the doctors come to after performing all testing and performing a physical exam?
Are they planning more tests?

You need to ask the doctor(s) your questions if you want a definitive answers. We are not doctors and do not know enough about your father's medical history to determine what caused his jaundice and the scan hasn't determined what caused his jaundice either.

1. I need to know actually how serious the patient's liver condition is? My patient is now at home, taking rest, taking medicine as prescribed by doctor.
Only your father's doctors who have been treating him can determine how serious his health condition(s) are.
All the CT scan mentions if that he has some unstated degree of liver disease.
Has he had a liver biopsy to determine the stage of his liver disease?
What medicine?

2. Can the patient be normal by taking medicine, rest and following diet roles?
Normal? The scan conclusion says he has liver disease. An enlarged spleen and liver.
What medicine?
What diet rules?

3. Does the finding suggest a liver transplantation?
The pathologist conclusion is that there is some unstated degree of liver disease because the liver shows inflammation but no mention of cirrhosis of the liver. Such as an enlarged spleen, nodular growths on the liver, etc..
"No abnormal enhancement is seen." I am not sure why you mention liver transplantation.

4.He was suffering from jaundice from last 2 months but now he has almost recovered from jaundice. Now he is almost normal condition. We had to give 4-5 bag blood over the last 2 weeks.
Did he lose blood somehow?
Why is he been given blood.

Please ask your father's doctor to explain what your father needs to do in the future to stay as healthy as possible. You might want to ask what else are they planning to do to determine what is causing your father's liver disease and can that be treated somehow.

Best of luck to the both of you. I am glad your father is getting better and recovering.

Hector
Avatar universal
Sorry for very less information from me but I am glad that you helped me with a lot of information.
Actually, I am from Dhaka, Bangladesh where medical treatment is not that much modern/improved. Even in our country we have no facility for liver transplantation.
My father used to live in a remote area and he was a regular Alcohol in taker but he stopped drinking from last 1 month. We all f=doubt his liver related disease/damage came from Alcohol.
He was suffering from jaundice for last 2 months. I am still not sure what was the reason of jaundice? May be from Liver damage?
We had to give 3 bags red blood and 2 bags plasma because  his blood's bilirubin was very high though not sure whether there are any other reasons.
My doctor did several hepatitis testing, blood testing, video endoscopy etc. After doing all the test my doctor said
1. Patient does not have the possibility of cancer. He did not tell me from where the jaundice came and I did not ask the question because I do have very less knowledge regarding this. I myself checked all the report and saw no hepatitis related disease exists. Also doctor did not tell me anything such.
2. Patient condition is not that much bad.
3.  Though he has advanced liver cirrhosis but still it is not major.
4. He gave several tablets ranging from antibiotic to liver medicine etc. If you need I can give all the tablet/capsule name here.
5.He advised to take right amount of protein, carbohydrate and only 1.5 liters water daily and no Oily/fatty food.  Also he is taking much rest at home.
6. Doctor advised me to meet after 1 month for follow up treatment.
7. Now my father skin color become to normal from yellow also he become a bit strong.
My Concern:
======================
1. I am now exactly sure what is the condition of my father. Actually here Doctor used to speak very less and it is also a bit frightening to ask more questions from them.
2. After proving CT Scan report to you guys I was expecting whether you could tell me actually how much danger the condition of my father liver is or any advice/suggestion what I can do further for my father. Actually here it is not possible to depend on Doctor 100% because they have too much patient and other activities.
3. Is there any possibility that my father might attack by jaundice again if liver does not improve much?

Sorry for all the question but it is tough to get good information here because people do not have much knowledge/experience regarding liver related complication.
Avatar universal
Thanks very much for all of these.

While we are taking advise from doctor, rest and medicine at the same time I am considering a possible liver transplant may be in India or Thailand. Out budget is low.

I have done some internet searching regarding this transplantation.

Seeing there are 2 ways for transplantation.First option is living donor with same blood group and another option is taking liver from dead person.

As my father blood group is O negative and it is very rare in my family so probably this option will be tough for us to manage a living donor.

The second option 'Dead man donor' might be the right choice for us but it is not straight forward also a lot of delay, dependency involved for this.

Could you please share experience regarding liver transplantation preparation, tips, execution, cost, post risk etc?

Patient:
===================
Age is 63 Y.

Has diabetes.

He also have the problem of piles(bleeding during toilet) but doctor pushed a ring there and also taking medicine. So bleeding during toilet stopped now.
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