Q: 57 year old female is admitted to ICU with sepsis. Patient also found to have severe jaundice and stigmata of liver cirrhosis and End-Stage Liver Disease (ESLD). Patient has no history of alcohol abuse. As you performed bedside ultrasound - liver appears very bright. What does it mean?
Answer: Probable Non-Alcoholic Fatty Liver Disease (NAFLD)
Diffuse fatty infiltration will give a bright appearance to the liver on ultrasound, which is technically described as a hyperechoic texture. This simple bedside procedure when correlated with history, laboratory findings, and other data, can confirm the diagnosis of NFLD with reliable sensitivity and specificity f 85 and 94 percent respectively. Said that liver biopsy is the gold standard to confirm NAFLD.
#hepatology
Reference:
Hernaez R, Lazo M, Bonekamp S, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology 2011; 54:1082.
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