Cirrhosis / not cirrhosis

[Lozza1234]

Hello. I had an ultrasound scan and hep consultation (privately) in Aug 20 which revealed fatty liver and early stage cirrhosis (coarse liver outline). I was then referred by my GP to the liver clinic at my local hospital and I had a Doppler portal vein and abdominal ultrasound this morning. The person who carried out the scan said there was no sign of cirrhosis but there is mild fatty liver. He also mentioned that my spleen was quite enlarged and that I had a cyst on my right kidney and a cyst in my pancreas. I have a follow up with the hepatologist booked in March but I wondered if anyone had experience of differing scan results like this? Historically I’ve had low platelets and fluctuating bilirubin levels. I’ve a history of heavy drinking (100 units + per week) but I’ve been sober for 2.5 years. The consultant I saw in 2020 said my scan, bloods and history suggested compensated cirrhosis, so I’m a bit baffled by the ultrasound findings of this morning. I am sure things will become clearer when I see the hepatologist next month, but I’d appreciate any info, especially in relation to questions I might ask at the consultation. Thank you for reading. x

[velvetunderground]

Hi Lozza - Accurate diagnosis of liver disease is really difficult - it performs so many functions and complains so little when under stress. Cirrhosis isn't black and white either, a borderline case might be considered mild cirrhosis by one consultant and severe fibrosis by another depending on how they interpret the results. It sounds like your latest diagnosis is potentially a better situation than the one last year and there could be many reasons for that, not least of which is that your continued abstinence from alcohol is going to give your liver the best chance to recover and it is certainly possible that it could be doing that.

In terms of questions to ask the hepatologist, then I'd suggest you should ask them exactly this question, and see what they say.

Sorry I couldn't be more helpful, hopefully others with more direct experience of ARLD might chime in too.

All the best

Paul.

[Lozza1234 in reply to velvetunderground]

Thanks Paul, that’s really helpful. I tend to look on the negative side generally but my husband also suggested that the fact that the latest sonographer couldn’t see cirrhosis could well be a positive sign! I have now taken time to jot down some questions so I will make sure I raise these when I see the hepatologist. Thank you again.

[deanw41]

Yes!! Ultrasound says one thing(depends who reads it) then consultant orders CT scan to be read by consultant radiologist. One says free flow in the portal vain,next one says portal hypertension,one says history of pancreatitis,one says no evidence. One says infiltration of fatty liver,one says cirrhosis,one says gall stones,.one says no gall stones!! I’m serious this is all true!!!!!! Your ultrasound can be read by a nurse with a bit of extra training!! When I questioned the difference in results,my friend Doctor said,who ever reads your ultrasound can be inexperienced and it’s largely open to interpretation!! I said that’s like telling me I’m pregnant then I’m not!! All I know is I feel bloody amazing for giving up the booze,and now I have a sweet tooth,so the ultrasound next time might say,cream slice with a bitten outline !!🤦‍♂️👍😊 good luck to ya that’s all I say!!!!

[Lozza1234 in reply to deanw41]

I hear what you’re saying! I too feel amazing after 2.5 years without a drink but the call of the cakes is strong! I’m not overweight, so I’ve got that in my favour, and I’ve now got my fingers crossed that when I finally get to see the hepatologist I’ll get a bit more information about what’s going on.

[deanw41 in reply to Lozza1234]

2.5 years is amazing!! I’m 8 1/2 months,getting there. Was decompensated with ascites this time last year,but loads better now. Last time I spoke to my consultant he said don’t worry,no I don’t anymore. I’m sober,eat well and work out and enjoy life!! I hope you get some clarity!!!