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Diffuse hepatic steatosis - grade III

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Gallstones?

Patient Data

Age: 60 years
Gender: Male

Liver ultrasound

ultrasound

Liver has diffuse increased echogenicity with posterior shadowing impairing the evaluation of the deep liver parenchyma and diaphragm. Liver contours remain smooth, no morphological features of cirrhosis. Focal fatty sparing adjacent to the gallbladder fossa. 

No biliary tree dilatation to suggest obstruction. Downstream CBD is obscured by overlying bowel gas. Gallbladder has thin and smooth walls and has mobile sludge within. Multiple gallbladder polyps measuring up to 1.0 cm. No pericholecystic fluid or gallbladder tenderness while examination. 

Bilateral non-obstructive renal stones. Kidneys are otherwise normal. 

Case Discussion

Liver showing diffuse increased echogenicity with posterior shadowing impairing the evaluation of the deep liver parenchyma and diaphragm, in keeping with severe hepatic steatosis (grade III). 

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