LIVER CIRRHOSIS AND ULTRASOUND SCAN

[JenBrown88]

Hi,

Does anyone know would a patient with cirrhosis reflect this on an Ultrasound scan? In particular the later end stages i.e decompensated cirrhosis.

My father had a US scan done which showed his liver findings as: normal in size, shape echo texture with no solid hepatic mass. An 8mm simple cyst within the right lobe. No evidence of intrahepatic biliary duct dilation. Patent Portal Vein. Dilated hepatic veins and IVC.

1 Day later after this scan he had a colonoscopy, he got an infection, then sepsis, and sadly died 13days later. The doctors said he had undiagnosed liver cirrhosis decompensating which was cause of death. However given the US scan done just days prior I would think this surely would have shown up something completely different than the above if he had end stage liver disease and cirrhosis?

Any help would be great as I'm just trying to get a better understanding of it all.

Many Thanks

[Hidden]

Sorry for your loss. I'm not 100 percent sure but the US is normally 6 monthly to check for changes. I'm compensated & most recent US in Aug Nurse said no abnormal lumps or bumps & test results would be compared with the previous one.

[JenBrown88 in reply to Hidden]

Thank you for your help and taking the time to reply, I really appreciate it.

[CarpeDiem11]

When you are decompensated, you will have varices or ascites or both. Varices are usually looked for via endoscopy, but some varices will only be seen on a CT scan.

Ascites can be seen on ultrasound, but very often they can be seen without ultrasound as there will be swelling in the abdomen.

It is common that as the liver disease advances, then the portal vein suffers, but the scan indicates there wasn't any clotting or blockages present.

I have had many ultrasounds and staging of liver disease is not mentioned, so I can't say with any certainty that the ultrasound would pick this up.

These are just my experiences though, so others may be better informed.

I am very sorry that your father has died in this way and no doubt left you with many unanswered questions. I hope that other peoples' posts will be able to add more to the picture and bring you some comfort.

[JenBrown88 in reply to CarpeDiem11]

Hi, thank you for taking the time to reply, it's much appreciated and does help, so thank you.

[CarpeDiem11 in reply to JenBrown88]

You are very welcome. I did look through the ultrasound letters that I have a record of and only one (from four) mentioned what stage the liver was at. I have had many more US, but very often as a patient you don't get a copy of the report. I always ask the operator for verbal feedback and since I know what stage I am at, I never ask for this information when scanned. I was decompensated at one point and it was caused by gastroenteritis, but this is unusual and not very common. I mention it only because there are cases that don't always fit the expected norm, so sadly your father may have been in this situation. I hope you are as well as can be expected under the circumstances and I wish you all the very best.

[JenBrown88 in reply to CarpeDiem11]

Thank you for looking back through previous letters, very kind of you. Interesting that the gastroenteritis led to the liver decompensating, did it reverse back to compensated after treatment for the gastroenteritis? the infection started in his bileduct they thought, perhaps the strain of the piccolax. My dad did have ascities, but they originally thought this was due to his heart valve had weakened. The ascitic drain was in process when he passed away, they had drained 7 litres approx of fluid but never administered any of the albumin which had been prescribed (100ml per 2 litre), he asked for the loo, and they moved him to the toilet and left him for around 10-15 minutes, he passed away suddenly it was too late by the nurses got to him. The consultant said that he would have fell unconscious and there was a lot of blood suggesting he haemorrhaged. We are doing ok thank you, it was just all so sudden in the end. Going in for a routine procedure and then it just went all horribly wrong within 2 weeks.

[CarpeDiem11 in reply to JenBrown88]

Yes, after treatment, I did go back to compensated. I've never had a drain fitted, but know that they are potentially a risk, although many people on here seem to have had them without a problem.

You have all had a terrible experience and your dad has suffered terribly by the sound of things. I'm very sorry that this has all happened. I know from speaking to friends that they have gone in for one thing, only to discover something else, which has delayed diagnosis. I myself have visited A&E to be misdiagnosed repeatedly. Sometimes there are so many things to rule out, they can't diagnose straightaway and the patient endures pain for longer.

I know this doesn't necessarily help, but perhaps it explains them not seeing things immediately. As for leaving him on the loo for so long with no- one in attendance, that to my mind should not have happened, but sadly it does not surprise me.

Sorry I can't be more informative and all the very best to you and yours.

[crowfordmccrow]

Not sure how it helps but my really really early diagnoses of cirrhosis was picked up on by US. I had a colonoscopy previous all clear, liver function test clear. But US picked it up. I suppose it's the competence of the operator. Mine was brills.

[JenBrown88]

Thank you for this, it's much appreciated.