Visible liver metastases: catch me if you can!
The following case has been reported in the National Medical Journal of India.

A 49-year-old woman presented with a history of upper abdominal pain for 2 months. The pain was present all the time, severe and did not radiate to the back. She also had high-grade fever with chills, loss of appetite and weight. She was a known patient of asthma on medications. A younger sibling had died of cancer that had caused abdominal fullness.

She was emaciated (body mass index 14.6). There was no pallor, icterus or generalized lymphadenopathy. Abdominal examination revealed enlarged liver with two liver nodules and a visible gallbladder.

The gallbladder was hard on palpation. Liver function tests showed elevated alkaline phosphatase (261 IU/L). Ultrasound confirmed mass in the gallbladder and multiple hypervascular metastases in both lobes of the liver. She was offered palliative care.

Major takeaway:-
A good history and meticulous physical examination can help avoid unnecessary expensive investigations in such cases.

Source: https://pxmd.co/W2RgD
M●●●j K●●●r and 10 others like this
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Dr. M●●●●●●●●●n S●●●●●●i
Dr. M●●●●●●●●●n S●●●●●●i General Surgery
To pick up a case of carcinoma of G.B. A high index suspicion to kept in mind for an early diagnosis. Because they usually present clinically late were it is advanced one. Curative treatment is not possible.
Nov 8, 2018Like2