FibroScan: Cirrhosis; CT Scan ?

[Ecabral07]

Hi everyone.

On 3/11/21, I got a FibroScan done that showed my KPA to be 22 and my CAP: 378. My primary doctor diagnosed me with Cirrhosis of the liver, and referred me to a Gastroenterologist.

I am 31 years old and in March 2021, I weight about 340 lbs

Immediately after the diagnoses I completely changed my diet and started walking. To this date, I have lost about 20 lbs. I currently weight 320 lbs.

On 3/29/21, I got to see the gastro, and he ordered a bunch of blood work and a CT scan. But he said, he didn't think I had cirrhosis yet, mainly because of my age, but that he couldn't say for sure. He said Fibro Scans can be inaccurate for people that are obese....I am due to see him again until June 2021, but all of my results have already come in to my medical record. Can anybody help me understand my CT results please? I know I need to wait for his official input, but just want to see what the community here thinks.

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FINDINGS:

Lung bases are unremarkable.

ABDOMEN:

The liver parenchyma is diffusely hypodense, consistent with fatty

infiltration. The liver is enlarged. The portal vein is patent. There

is no biliary dilatation. No enhancing liver masses are identified.

Cholecystectomy clips are noted. The pancreas, spleen, adrenal

glands, and kidneys appear normal as visualized. The visualized

portions of the bowel appear normal. There is no lymphadenopathy.

There is no free air or free fluid in the abdomen. The visualized

bones appear normal.

IMPRESSION:

Hepatomegaly. Fatty infiltration of the liver.

No liver masses identified.

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My liver enzymes are elevated. My AST was 47 from October 2020, and my ALT was 164 in March 2021.

Thank you in advanced!

[nash2 Partner]

It is true the very obese people are hard to diagnose definitively with FibroScan but you do know for sure that the organ is enlarged from the CT and liver cells are being damaged as indicated by the ALT. The question your doc needs to answer is how much scarring has really taken place but it doesn't matter too much what you call it. You certainly need to get it under control as you are in a high risk situation and just saying you don't have cirrhosis isn't really very helpful. That fibrotic disease process has four stages. Stage 4 or F4 is also called cirrhosis but F3 is a serious concern as well so getting the weight under control is very important.

[Ecabral07 in reply to nash2]

Thank you so much for the feedback. I have an appointment with a different gastro this Wednesday and I will ask that question. Thank you, because usually when we go to the doctor we don’t even know what to ask.

One weird thing is that after my diagnosis in March, I began to feel discomfort in my upper right stomach—- liver area. But before the diagnosis I didn’t felt nothing. I’m not sure if my liver diseases is progressing rapidly or if the discomfort is all in my brain.

Nonetheless , thank you for your help. Please!! If there’s anything worthy I should ask the GI, please let me know.

[nash2 Partner in reply to Ecabral07]

Well, you almost certainly have a liver in distress so can he help you understand how to stop it from getting worse and can he help you get your weight down. Unless you have some autoimmune condition that is the only current therapy available. It would be good to have a baseline such as the 22kPa that your doc thought was a reliable reference to be able to measure your progress in the future but finding ways to get your weight down is job one and can he help you with that.