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Suffering from fever, indigestion, stomachache and frequent urination. Ultrasonography done. Advise?

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Gastroenterologist
Practicing since : 2001
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Hello Doctor, My father aged about 58 years is suffering from fever, bulged stomach with indigestion and having severe unbearable stomach and ribs pain , frequent urination.
uneasiness in breathing. No Appetite and has problem in digestion.
We visited nearby hospital and doctor advised us to get scanning done. after taking medicines and injections he has no fever now. but all other problems still exists.
He has smoking and drinking habits.
i have given the Scan results below. please check and let me know what should be done.

ABDOMINO-PELVIC ULTRASONOGRAPHY
LIVER is enlarged in Size. There is evidence of multiple heteroehoic ill defined areas predominantly in the right lobe (segments VI, VII and VIII) conglomerating to form large lesion measuring 10.0 x 8.0 cms. Cystic as well as hyperehoic areas seen within the lesion with no abnormal vascularity. There is evidence of Focal Hypoechoic lesion with echogenic wall in segment IV measuring 3.7 x 2.8 cms with no abnormal vascularity. There is evidence of heteroechoic lesion in left lobe of liver measuring 5.5 x 4.0 cms, no abnormal vascularity seen within. No evidence of intrahepatic biliary ductal dilatation. Hepatic and portal vein radicals are normal.
GALL BLADDER is partially contracted. Gall Bladder wall is of normal thickness. CBD is of normal caliber.
PANCREAS body of pancreas is visualized and appears normal. The head and tail evaluation is suboptimal. No evidence of ductal dilatation or calcification in the body.
KIDNEYS move well with respiration and have normal shape, size and echopattern. Cotico-medullary differentiations are well made out. No evidence of calculus or hydronephrosis.
URINARY BLADDER shows normal shape and shows wall thickening measuring 5mm. it has clear contents. No evidence of diverticula.
Prevoid: 103cc Postvoid: 90cc
PROSTATE shows normal shape, size and echopattern. It measures 3.0x3.6x3.6 cms (Vol-21cc)
Right basal consolidation noted

IMPRESSION:
     HEPATOMEGALY WITH MULTIPLE FOCAL LESIONS IN LIVER AS DESCRIBED – POSSIBILITY OF LIVER ABSCESS OVER NEOPLASTIC LESION TO BE CONSIDERED.
     CHANGES OF CYSTITIS WITH SIGNIFICANT POSTVOID RESIDUE.
     RIGHT BASAL CONSOLIDATION.

Posted Fri, 1 Mar 2013 in Digestion and Bowels
 
 
Answered by Dr. Abhijit Deshmukh 42 hours later
Hi,
Looks like a serious problem.
Possibilities could be either a cancer with multiple liver metastasis or multiple liver abscess.
We need to get a needle aspiration of this lesion (biopsy) to see the etiology (as mentioned above).
Tests, which will help additionally, are a CAT scan abdomen with tumor markers like CEA, CA 19-9, PSA, and AFP additionally.
If it is, an abscess then may need to be drained using a pigtail in the larger lesion along with antibiotic therapy.
I think he should be hospitalized for a quick evaluation of above-mentioned etiologies.
Hope this answers your query.
Wish him a speedy recovery.
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