Posts by crimsongull94

vividsailor7 said:Don't throw "ECT" at me under diagnoses and expect a coherent response.
I was being a bit vague about the Hepatocellular carcinoma in my previous post, but I still need the rest of the blood work and X-ray results to be specific.
A BLOOD PRESSURE LOG IS MANDATORY!!!

Regarding diagnoses: there's also pleural effusion on the right side, hypertension, and Strabismus.
Chest X-ray: PA projection shows a homogenous shadow on the right reaching up to the anterior margin of the 3rd rib, consistent with pleural effusion. On the left, the border is sharply defined, mostly positioned against the free left lateral costophrenic sinus. The right hilum isn't distinguishable. The heart shows prominent left chamber contours, displaced due to the elevated diaphragm.

BP was 150/90 upon admission, though they say it was adjusted. We don't have a BP log; it stayed on the temperature sheet. Today it's 115/65.

Bloodwork... RBC 3.73
Hb 120
Htc 0.345
L 6.6
Trc 78
Diff: eo 2
bazo 1
seg 62
linf 23
mono 12
CRP 20

GLU 4.9
bilirubin 27 umol/l
urea 6.6 mmol/L
uric acid 314 uM
s creatinine 120 uM

ALP 110 U/L
AST 175
ALT 48
gamaGT 22
CK 123
LDH 269

K 4.1 mM
Na 134 mM
Cl 109 mM
Cu 24 uM
Fe 13 uM
ceruloplasmin 0.36 g/L
ferritin 202 ug/L

PV INR 1.2
APTV 31.8s
fibrinogen 1.7 g/L

Hopefully this helps you figure things out. 🙂 Thanks. 🙂)

Hi everyone. I’m posting here because I’m running out of places to turn. It’s about my father—he's 59 and just got discharged from Internal Medicine with an urgent recommendation for an outpatient liver MRI.
He was hospitalized for decompensated liver cirrhosis (alcohol-related, Hepatitis C positive). The gastroenterologist ordered a CT angio because his ascites made a decent Ultrasound impossible. The CT angio shows: pleural effusion at the lung bases; esophageal thickening due to varices; a small liver with wavy contours and inhomogeneous, diffuse, mottled parenchyma. There's a 0.5cm hypovascular change in the left lobe (maybe a cyst?), and a 1.4cm avascular lesion in segment 5. Right next to that, caudal to the lesion, there's a 2.8cm focal lesion that's inhomogeneously hypervascular during the arterial phase and inhomogeneous in the venous phase, though one part is visible in the delayed phase. The etiology is unclear; it could be a primary tumor or something else. No obvious pathological arterial vascularization is seen, and there isn't a complete wash-out in the later imaging phases. His spleen is enlarged, the splenoportal axis veins are patent, and the portal vein is 1.4 cm. There are also enlarged lymph nodes (3-5 cm) near the portal vein and the atrophied pancreas.

Discharge diagnosis includes: HCC vs. observation; Hepatitis C; Cirrhosis, Child-Pugh B; bacterial peritonitis; grade III esophageal varices, etc.

Long story short: they want an MRI ASAP. But get this—they couldn't even schedule it at the biggest hospital in the area. The waitlist is massive.
Does anyone with actual experience know how urgent this really is? Are we talking days or weeks? And what are the odds this is actually HCC? Can an MRI rule it out entirely?

One thing I forgot to mention: his alpha-fetoprotein is 124 ug/l. They haven't determined the HCV titer yet. He’s on antibiotics and a ton of diuretics, but the ascites isn't draining well... plus he has "mild" edema in his legs. Shortness of breath, frequent coughing, shallow breathing—it's all become his "new normal." How long does it usually take for diuretics and steroids to start working? His current regimen is: Aldactone 100mg; Lasix 2 x40mg; Ramed 5mg; Norvasc 10 mg; Physiotens 0.4 mg; Propranolol 2X20 mg, and Controloc 40 mg. Thanks a lot. 😳))