Thursday, September 17, 2020

Ultrasound in ESLD

 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.



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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