Gastroenterology
Case 29: A Man with Abnormal Liver Blood Tests
CASE
A 37‐year‐old man is referred for an opinion regarding abnormal liver blood tests. These were identified as part of a routine ‘screening’ health check arranged by his employer. He has no symptoms. His weight has gone up by 12 kg over the previous 5 years since having a family. He drinks alcohol no more than twice a week. He is on no regular prescribed medications and has no family history of liver disease.
On examination he looks fit and well. He weighs 120 kg (BMI 34). He has no peripheral signs of chronic liver disease and abdominal examination is normal.
Blood tests showed:
Hb 14.5 g/dL WCC 6.7 × 109/L Platelets 276 × 109/L PT 11 sec Glucose 5.6 mmol/L Na 142 mmol/L K 4.3 mmol/L Urea 4.7 mmol/L Creatinine 100 µmol/L Albumin 41 g/L Bilirubin 14 µmol/L ALP 150 U/L AST 110 U/L
Ultrasound showed increased reflectivity of liver parenchyma with increased prominence of portal tracts. There was no focal liver lesion. His bile duct, kidneys and spleen were normal. His pancreas was obscured by overlying bowel gas.
QUESTION 1
Your score this session: 0 of 0
The ultrasound report is consistent with which pathology?