Liver - Part 4 Flashcards
What is the cause of cysts? (2)
- Acquired secondary to parasitic infection, inflammation, or trauma
- True cyst is caused by a weakening of a bile ductile
What are clinical findings of cysts? (2)
- Asymptomatic
2. Dull RUQ pain
What is the US appearance of cysts? (6)
- Anechoic
- Round- or oval-shaped mass
- Well-defined
- Smooth wall margins
- Posterior acoustic enhancement
- May contain septations or low-level internal echoes
Cystadenoma
Benign neoplasm containing cystic structures within the lesion
What is cystadenoma most common in?
Middle-aged women
What are clinical findings for cystadenoma? (2)
- Hepatomegaly
2. Palpable RUQ mass
What is the US appearance of cystadenoma? (4)
- Multiloculated cystic mass
- Well-defined margins
- Thin septations demonstrating thin wall margins
- Thick septations or mural nodules are suspicious for malignancy
Who is polycystic disease more common in?
Middle aged females
What are the clinical findings of polycystic disease? (4)
- Asymptomatic
- Hepatomegaly
- Palpable RUQ mass
- RUQ pain
What are 3 types of abcesses?
- Amebic
- Fungal
- Pyogenic
What is the most common cause of an abscess?
Ascending cholangitis
What are the causes of an abscess? (4)
- Recent travel abroad
- Biliary infection
- Appendicitis
- Diverticulitis
What are the clinical findings for an abscess? (6)
- Abdominal pain
- Fever and chills
- Leukocytosis
- Elevated alkaline phosphatase
- Jaundice
- Hepatomegaly
What is the US appearance for an abscess? (5)
- Complex mass
- Oval or round shape
- Irregular wall margins
- Usually solitary
- Posterior acoustic enhancement
Which lobe of the liver are abscesses most common in?
The right lobe
- 80%
What kind of infection is candidiasis?
Fungal
What are clinical findings for candidiasis? (3)
- Abdominal pain
- Fever and chills
- Palpable liver
Who is candidiasis common in?
Immune-suppressed patients
What is the US appearance of candidiasis? (5)
- Uniformly hypoechoic lesions within the liver parenchyma
- Thick wall margins
- Hepatomegaly
- May demonstrate a target or “wheel within a wheel” appearance
- Hyperechoic lesions with posterior acoustic shadowing
What causes echinococcal cyst?
Recent travel to underdeveloped countries
What are the clinical findings of echinococcal cyst? (5)
- RUQ pain
- Leukocytosis
- Fever
- Hepatomegaly
- Elevated alkaline phosphatase
What is the US appearance of echinococcal cyst? (6)
- Septated cystic mass (honeycomb)
- Mobile internal echoes (snowflakes)
- Cyst containing smaller cysts (daughter cysts)
- Collapsed cyst within a cyst (water lily sign)
- Round or oval shape
- Smooth wall margins
What is hepatitis B transmitted by?
Inoculation of infected blood or body fluids
What does hepatitis B increase the risk of developing?
Hepatoma
How is hepatitis C transmitted?
Blood transfusion or “dirty” needle
What does hepatitis C increase the risk of developing? (2)
- Cirrhosis
2. Hepatic neoplasm
What are the clinical findings of hepatitis? (5)
- Fatigue
- Loss of appetite
- Fever and chills
- Nausea
- Non-obstructive jaundice
What lab values are elevated with hepatitis? (3)
- Aspartate aminotransferase
- Alanine aminotransferase
- Bilirubin
What is the US appearance of hepatitis? (6)
- Normal-appearing liver parenchyma
- Hypoechoic liver parenchyma
- Prominence of the portal veins (starry effect)
- Hepatomegaly
- Associated splenomegaly
- Increased parenchymal echogenicity in chronic cases
