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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I am a 54 year old male diabetic.(onset 1992) Weigh 205lbs.

Customer Question

i am a 54 year old male diabetic.(onset 1992) Weigh 205lbs. Had my gall bladder removed about 7 years ago. I have fatty liver. I had a few bouts of severe pain in the center under my sternum...twice had to go to the emergency room. Those happened about 6 months ago. I have not had any more sever pains but once in a while a very mild stomach ache. In fact they are becoming more and more infrequent. No jaundice, no fatigue, no nausea, no weight loss, stools look fact i feel fine. My Primary Dr gave me an ultrasound about 4 months ago and it came back normal. Had another Dr do another ultrasound and the results are as follows:
The liver size is in the normal range. There are echogenic foci with distal acoustic shadowing in the left lobe of the liver. The significance of this is uncertain. The findings could be due to calcifications in the left lobe. The echogenic texture is
otherwise homogeneous. There is no intrahepatic duct dilatation. Common bile duct is normal in caliber.
The gallbladder was not defined and correlates with a history of a prior cholecystectomy.
The pancreas was not clearly defined.
There is no hydronephrosis in the right kidney. The spleen is not enlarged.
1. There is an ill-defined 18 x 10 mm echogenic focus with distal acoustic shadowing in the left lobe of the liver. This could be secondary to calcifications in the area or this could be secondary to clips in the gallbladder fossa. A CT scan of the liver without and with contrast is recommended.
2. Biliary tree is not dilated.
I just had a CT scan with and without contest...awaiting results
I am not sure how to understand the ultrasound diagnostics above.
What does an ill-defined echogenic focus mean? Is it worse than a well-defined echogenic focus?
Is the size 18x10 mm very big?
Also i was wondering how the first ultrasound didn't catch the spot like the second ultrasound 3 months later.
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 4 months ago.


What it is: they saw some type of object, whether calcification, surgical clips or mass.

A ct will show what it is. Ultrasound is not accurate.

Accuracy down, then the first might have missed the area.

Or it is new 3 months later.

Those are all the possibilities.

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