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Stomach pain, fever, vomiting. Ultrasound showed hepatomegaly with renal cysts. On antibiotic. Is the report normal?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Hi, the father ( 63 years old) of a friend of mine has received an ultrasound report which states as follows:
"hepatomegaly with diffuse parenchymal change hepatic cyst delayed left intrahepatic duct and radicles, spleen, abdominal aorta, urinary bladder and prostate minimal ascites in the lower abdomen suggest clinical correlation. duct and radicles cholecystitis bilateral medical renal disease renal cysts, bilateral normal pancreas". The patient is experiencing severe stomach pain, fever n some bouts of vomiting. Is currently hospitalised and receiving antibiotic treatment. ? how serious is his condition and is it his gallbladder or liver that has problems?
Posted Mon, 13 May 2013 in Digestion and Bowels
Answered by Dr. Ketan Vagholkar 25 minutes later
thanks for writing in.
The condition of your friend's father is critical. There are many issues in the case.
1. The liver problem of diffuse parenchymal change points towrds two possibilities. Either cirrhosis or changes associated with cystic changes in the liver.Besides this there is also a component of cholecystitis which can get worst. However further details pertaining to the liver and gall bladder are required for more clarity to arrive at a diagnosis. This has to be correlated to liver function tests as well.
2. Bilateral medical renal disease (cystic lesions) is another issue for which further investigation in the form of a focussed ultrasound and renal profile is required to quantify the severity of renal compromise.
The abdominal pain may well be due to the gall bladder problem .While the ascites well could be due to either hepatic compromise or even due to failing renal function. Liver function tests along with renal function tests will help in identifying the exact cause. Fever suggests infective problems in the gall bladder.
A proper work up with respect to the risk involved is necessary to chart the further course of action that is whether medical or surgical options can be exercised.
I hope this answers your querry.
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