results

[seansmum72]

I have had an ultrasound and now an endoscopy with differing results I had my endoscopy on friday and the letter i received says site 2 vascular lesions, portal hypertensive gastropathy with no bleeding, site 4 antrum vascular lesions, watermelon stomach with no bleeding site 6 sub-mucosal lesion. Nobody explained any of this to me, but the letter i received from the ultrasound (which was done the week before) says no worrying or focal liver lesions and main portal value was normal. can anyone shed any light on what this all means please.

[Neerav1234]

I think going by my own experience mind you I am no doctor my ultra sound indicated coarse liver major liver problems are thrown up by ultra sound only in advanced cirrhosis which you don’t have but you have liver issues no doubt how are the enzyme levels

[CarpeDiem11]

The ultrasound would be looking for different things to an endoscopy, which is why they don't give the same results. The endoscopy is to look for varices. When the varices are small, they are left alone. If the varices are over a certain size,then they are checking to see if they have been bleeding and then they will carry out what is called banding.

I'm afraid due to site rules, none of us are allowed to interpret your results, so I would advise you to call the Consultants secretary and ask them to get back to you to explain it. The naming of sites 2, 4 and 6 is usually done in reference to a picture where these are labelled. Again only your Consultant can explain this to you. It would be usual however for them to see you again in 12 months time for another endoscopy and 6 months for an ultrasound, but this could vary depending on many things.

The ultrasound is checking for the blood flow through the main vein serving the liver, called the portal vein. Yours states it is normal. The ultrasound is also checking for cancerous growths, hence the liver lesions phrase.

I hope this answers some of your questions. Maybe you could book to see your GP, who could explain since they might have a copy of the endoscopy report. All the very best.

[Kristian]

Hi Seansmum,

You'll generally find neither the sonographer, who did your ultrasound, or the endoscopist will generally discuss your results with you after the process. They will generally leave that for your consultant at your next appointment. They will generally just report what they see and leave the interpretation of what that means to your consultant who generally has more of the fuller picture.

As carpediem says, the ultrasound and endoscopy look at different things. The ultrasound will give an image of what your liver sort of looks like and the endoscopy what the inside of your oesophagus and stomach look like. You've already had a biopsy that showed that you have cirrhosis, I picked that up from one of your earlier posts, so that diagnosis is clear. The ultrasound and endoscopy is pretty much part of the usual screening process for any one with cirrhosis. The ultrasound is looking to see what size and texture your liver is to try and get some idea as to the progression of the cirrhosis. It is also looking for any signs of potential cancer and how blood is flowing through the organ and the veins serving it. It will also look at your spleen size too. Portal hypertension is quite common with cirrhosis and one of the tell tale signs of that is that both the liver and the spleen are larger than normal.

The endoscopy is looking for signs of portal hypertension also, or more importantly the ramifications of portal hypertension - oesophageal and fundal varices. The reason for that is that they can rupture leading to severe bleeding. They therefore want to try and find them and treat them before they get to that stage if they can, hence the endoscopies. If no varices are found then the frequency of endoscopy is less than if they are found.

You refer to the finding of "Portal Hypertensive Gastropathy" on your endoscopy report. This is found in Portal hypertension, as the name suggests, and it relates to the appearance of the lining of your stomach through the endoscope. Its a sort of snake skin or mosaic looking appearance. You also mention the findings of "Watermelon Stomach". That I admit I had to look up, and what came back was a condition called Gastric Antral Vascular Ectasia" or "GAVE". From what I read on good old Wikipedia that condition can be associated with cirrhosis but also with a few other things too. Hence the reason your endoscopist will never try and give any sort of diagnosis or explanation.

So what does this all mean for you? Well really only your consultant can advise on that. He or she will take the observations made by the sonographer and endoscopist and look at them in view of your other tests and come up with a more formal diagnosis. They will also look to see if some additional medication is required. If you have portal hypertension they may want to try and start you on a beta-blocker for example. If its not advanced enough the may choose to wait, but that is the sort of thing they are looking for.

Hope that's helpful. Getting a diagnosis for any form of liver disease can sometimes take a long time. The key thing is that they continue to monitor you and make interventions when they become necessary. From what you have said already, it looks like they are doing just that so you seem to be in good hands. Next time you have an appointment make sure you go with any questions that you would like answers too. They are usually more than happy to respond. It makes it a more interesting appointment for them too.

[seansmum72]

Thanks for the responses. I have today received another letter to say i have to go for an ultrasonic endoscopy next week but still no letter to see the consultant who I have only seen once since I was diagnosed, so I will wait till next week to see what they say and see if I can get an appointment with the consultant. Thanks again

[CarpeDiem11 in reply to seansmum72]

I never get an appointment to see a Consultant when I've had an endoscopy. For me, the endoscopy has been a procedure carried out, with a report given at the end and no-one explains any of it. I get my explanations when I do get to see the Consultant, but this could be some time after.

Maybe things will operate differently in your area, but if not and you are worried, then it is probably best to phone the Consultants secretary.

On the other hand, I find the sonographers very helpful. I've been shown my portal vein, the blood flow and had explanations.

All the very best

[mncold]

Hi seansmum72,

It sounds to me like you need to start calling your consultant's office to find out what is going on and how they intend to go forward.

You have gotten some good advice on here from others, but my advice is to start calling your doctor for info or an appointment to go over the test results.

Best wishes,

Mary

[Bootandall]

Hi seansmum72 (big fan of the zombie movie, your moniker tickles me, hope you're laughing), I have portal hypertensive gastropathy too, what did your doctor say? I've always got a mild tummy ache, do you? Really any information at all beyond the clinical is what I'm wondering. I don't have any idea if my beta blocker is helping, but I'm not actively bleeding so that's good.

[seansmum72 in reply to Bootandall]

They haven't said anything to me got an appointment on the 29th of this month so hopefully will find out more then. I am at a loss as what to do as It has been 18 months since I got diagnosed and they have not told me anything, no lifestyle changes nothing, so hopefully this appointment will tell me something.

[Bootandall]

Thanks, keep me posted. Take care.