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Family Physician
Family Physician, Doctor (MD)
Category: Health
Satisfied Customers: 12816
Experience:  Emergency Medicine and Family Practice for over 26 years
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recently visited ER for upper abdominal pain ultrasound

Customer Question

recently visited ER for upper abdominal pain ultrasound presented the following: (quoting the report) "Liver appears to be normal size. There is a heterogeneous appearance of areas within right lobe of the liver. There is one axial area measuring 1.68 x 1.25 cm which is nodular. There are areas of heterogeneous increased nodular hyperechogenicity seen within portions of the liver in a nonsegmental segmental pattern".
There is an abnormal parenchymal pattern within the liver. There are nodular areas of increase echogenicity compared to the surrounding hepatic parenchyma. There is one rounded nodular area within the right lobe. It is possible that these could be related to fatty infiltration of the liver with inhomogeneous infiltration with areas of fatty sparing but I cannot exclude infiltrative or nodular disease."
My blood labs were as follows: White Blood Count 9.6 (range 3.8 - 10.8)
Red Blood Count: 3.98 (range 3.80 - 5.10)
Hemoglobin: 12.6 (range 11.7 - 15.5)
Hematocrit: 37.7 (range 35.0 - 45.0)
MCV: 95 (range 80 - 100)
MCH: 31.5 (range 27-33)
MCHC: 33.3 (range 33 - 36)
RDW: 13.5 (range 11.0 - 15.0)
Platelet Count: 403 (range 140 - 400)
MPV: 7.7 (range 7.5 - 11.5)
Absolute Neutrophils: 7382 (range 1500 - 7800)
Absolute Lymphocytes: 1584 (range 850 - 3900)
Absolute Monocytes: 518 (range 200 - 950)
Absolute Eosinophils: 67 (range 15 -500)
Absolute Basophils: 48 (range 0 - 200)
Neutrophils: 76.9%
Lymphocytes: 16.5%
Reactive Lymphocytes: 0.0
Monocytes: 5.4
Eosinophils: 0.7
Basophils: 0.5

still experiencing upper abdominal discomfort. Gallbladder is fine per ultrasound.

Would you please help me to understand what this means?

Submitted: 6 years ago.
Category: Health
Expert:  Family Physician replied 6 years ago.
Since the impression on the ultrasound report raises concerns about a number of conditions including fatty liver, I do believe that a MRI or CT of the abdomen and possibly even a liver biopsy may be necessary.

I would suggest making an appointment with a gastroenterologist to review these findings and discuss the best approach to investigating these symptoms and these ultrasound findings.
Family Physician and 6 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Do the labs indicate possible issues that would substantiate the ultrasound findings?
Expert:  Family Physician replied 6 years ago.
The lab results are essentially all within normal limits. There is nothing in these labs that is worrisome.

You doctor may want to do some additional tests for liver function to better elucidate the importance of these ultrasound findings.