Diffusly enlarged liver

[ThyroidDeb]

1.5 years ago while getting a GI cat scan they noticed nonalcoholic fatty liver. Doctors didn't seem concerned so I wasn't either. Fast forward 2021, I had stomach pains for 2.5 months recently but not unusual since I have gastritis until one evening, they were more serious to me. Made doctors appointment and she in turn set up an ultrasound and blood work. Blood work for liver was all in standard range but AST was 56 scale is 10-40 ALT was 38 scale 2-45. The ultrasound showed no focal lesions, no ascites but liver measures 24.5 cm. Bile duct was a little enlarged but not much different from last CT. Their diagnosis is, liver is diffusly echogenic suggesting hepatic steatosis or diffuse hepatocellular. Needless to say, I don't understand a lot and even research hasn't told me much. Follow up appointment in another week and she did a referral to my gastroligist last week. It's been a week now and I have not heard from gastro as yet, not sure if this means it's not considered that serious and they are in no hurry or they are just busy..in research I didn't see any liver measurements as large as mine, largest was 21 cm to me it seems serious. Any ideas?

[nash2 Partner]

Hi Deb

They are suggesting that you have a fatty liver but as you suggest the question of why you liver is enlarged, probably inflammation, and the AST/ALT ratio being high suggests that you should get your liver tested for stiffness as a reasonable next step. It is good that your primary referred you to a gastro doc but if that doesn't answer your questions request a referral to a hepatologist. Several things can cause your issues so getting it sorted out is the right next step.

Wayne

[ThyroidDeb in reply to nash2]

Hi Wayne, thank you. How exactly do they test for stiffness? What I have read is 7 cm is normal size for female liver 10.5 cm for male but there are also a lot of ther things taken into account to determine. I also read that if the ALT is high and AST is normal it is probably just a fatty liver problem where if AST is higher and ALT normal it could be hepatitis, cirrhosis, or cancer. Guess I won't know until I get there. What shocked me the most was liver size and not finding any online that large with other people!! Thanks again.

[nash2 Partner in reply to ThyroidDeb]

We see livers that large at times and definitely a concern. They measure stiffness by tapping or vibrating the liver and measuring how fast that impulse moves through the tissue. The "rules of thumb" such as the blood values aren't really diagnostic so they can help guide a doc but give a sense of probability rather than evidence. Best wishes