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I have pain in the upper right quadrant of my stomach around the liver. I have had an Upper G.I. & a Lower G.I.. I also, had a Colonoscopy and several CAT scans of Liver, and Ultrasound of Liver. The Ultrasound found an Enlarged-Liver. I had two Liver Biopsies: both found inflammation of Liver? Tested for Porphyria, Lupus and several other diseases: all tests were negative. My CBC is always a different count: one time red is high and white is low, then white is high and red is low never normal. I have Osteoarthritis of both my feet, knees and neck. I also have severe Varicose veins in both legs. I had my gallbladder removed, Biopsy showed chronic inflammation. (They do not what kind of VIRUS or what ever I had.)
In March, 1993 I told my doctor of pain in the upper right quadrant of my stomach and chest. The doctor said I pulled a stomach muscle, from carrying my camera bag. (I am a
Professional Photographer, and I did all my own B&W processing and printing, and I did
R&D in my darkroom.) I am a White Male, age 52.
10. For over two years now I have been unable to wear shoes, for my feet sweet and swell up and turn red on bottom and sides. 11. The more I move around the more pain I have in URQ, and if I bend over it feels like something is pushing up into my right lung 12. High eye sensitivity to sun 13. A fowl taste in mouth, like an abscesses but I have upper and lower dentures and at times my mouth tastes tinny. 14. My Left leg is hurting more and more,
right leg hurting but as much. Radiology Report, RT Shoulder, Humerus, Hand, Foreman & Elbow 3/28/94 Multiple views of the right arm were obtained. There is no fracture or dislocation. Evaluation of the shoulder reveals sclerosis in the region of the greater tuberosity of the humerus, most likely related to tendinitis. No calcification is present in soft tissues in this region. A bony sour is present in the distal humerus, anteromedially. IMPRESSION, Tendinitis at the insertion of the rotator cuff tendon. Radiology Report, Chest PA and Lateral, 11/3/94 The lung fields are satisfactorily aerated. There is no pleural effusion. The trachea is undisplaced and the hilar shadows are normal. The diaphragm is well arched. The heart and great vessels are unremarkable. The left 1st. Rib has been resected. IMPRESSION, No evidence of recent or active pulmonary disease. Aside from the
absent left 1st rib, the chest is unremarkable. Diagnosis: Thrombophlebitis of left lower extremity. Hospital Course: Patient placed on intravenous antibiotics, consisting of Ancef, was started on
Heparin therapy for anticoagulation, however, prescribed bed rest and warm compresses to
lower extremity. q. six hours. Also, patient in hospital was anticoagulated with Heparin drip and
started on Coumadin therapy to get his PT in the therapeutic range. Medication On Discharge: 1. Augmentin 500 mgs. 1 po. t.i.d. for 14 days. 2. Coumadin 2.5 mgs. daily until further advised. Radiology Report, Barium Enema - Air Contrast, 3/23/95 The entire colon was well visualized. No concentric lesion, polyps, ulcerations nor other mucosal abnormalities are demonstrated. Some diverticula are noted. No other significant findings are seen. CONCLUSION, Mild diverticulosis. Tics predominantly in sigmoid and descending
colon. Preliminary scout film of the abdomen demonstrates no evidence of radiopaque
densities to suggest calculi. The intestinal gas pattern is within normal limits. There
are several small areas of retained barium in colonic diverticula from a recent barium
enema. CONCLUSION, Small hiatal hernia. Radiology Report, B-Scan ABD Complete, 5/1/95 The length of the right hepatic lobe is 19.26cm, indicating mild hepatomegaly. There is slight decrease in the visualization of the peripheral portal venous vasculature raising the question of a chronic hepatic inflammatory process vs a small amount of fatty infiltration. Please correlate clinically. The gallbladder was appropriately distended without thickening of the wall, pericholecystic fluid or contained sludge or stones. The region of the gallbladder is where Mr. Haggerty reports his primary discomfort, and therefore acalculus CHOLECYSTITIS cannot be excluded. The right kidney appears normal. The pancreatic duct is top normal size but the pancreas is otherwise unremarkable. IMPRESSION, Mild hepatomegaly with slightly abnormal liver texture raising the question of fatty infiltration and/or a mild chronic hepatic inflammatory process. Normal appearing gallbladder with pain centered over the gallbladder raising the question of acalculus CHOLECYSTITIS. Associate Director, Center for liver Disease. 5/26/96 Mr. Haggerty's main risk factor for liver disease is alcohol. He was a heavy drinker up until 1980. He drank on a daily basis, mostly scotch. He denies any history of hepatitis or jaundice (neonatal or otherwise), blood transfusions, IV drug abuse, occupational exposure to blood or bodily fluids, or family history of liver disease. Impression: 1. Hepatomegaly of unknown cause. 2. History of rectal bleeding. 3. History of hematemesis. 4. History of duodenal ulcer. Plan: 1. Presence of hepatomegaly indicates hepatic pathology. I explained to Mr. Haggerty that he will need a liver biopsy to accurately access the severity and etiology of liver disease. He will need viral serologies, iron indices, autoimmune panel, alpha-1-antitrypsin level, etc. I will do a liver biopsy when these results are obtained and Coumadin is stopped. 2. The patient should have a sigmoidoscopy to evaluate rectal bleeding. While it
is most likely due to hemorrhoids, other causes will be investigated. Radiology Interpretation, 6/24/95 Radiology Report, On the preliminary scout film of abdomen there is prominent loops of small bowel
throughout the abdomen. The large bowel is nondistended. There are no radiopaque densities
to suggest calculi. There are several phleboliths within pelvis. there is no evidence of hydronephrosis or obstructing calculi. There is however
left renal collecting system abnormalities as described above suggesting a cystic or solid
renal mass. An ultrasound is suggested for further evaluation. Surgical Pathology Report 50 year old white male of Irish descent with hepatomegaly. History of excessive
ETOH use. Stopped for many years. Serology for hepatitis B, C negative. Rule out chronic
active hepatitis. Rule out hemochromatosis. The specimen is received in two parts, both labeled "LIVER". The section above shows liver parenchyma with preservation of the usual architecture. Portal spaces are not expanded. There is no evidence of portal inflammation nor piece-meal necrosis. A few small collections of benign mononuclear cells, mostly lymphocytes, are seen in the liver parenchyma; some of these are located adjacent to central vein. The sinusoids are dilated in some areas. The hepatocytes show slight focal regenerative changes. There is no bile duct proliration. Fibrosis is not seen. Bile stasis is not noted. Special stain for iron demonstrates minimal iron. Special Stains: IRON Diagnosis: LIVER BIOPSY: LIVER TISSUE WITH FOCAL REGENERATIVE CHANGES AND MINIMAL, CHRONIC INFLAMMATION OF UNCERTAIN ORIGIN. FOLLOWUP AND CLINICO-PATHOLOGIC CORRELATION IS SUGGESTED. Comment: A verbal report given to Dr. Rothstein on July 6th 1995. MM MARIA MILCU M.D. ____________________________ 07/10/95 (Electronic Signature)
Radiology Report, B-Scan ABD Complete, B-Scan Flow ABS/Pelvic Organs 09:05 7/20/95 Ultrasound of the abdomen and duplex color Doppler of the biliary vessels was performed. The previous sonogram is not locatable at this time and thus the report is rendered in comparison with my previous report of the sonogram performed 5/1/95. The Liver remains mildly enlarged and appears to be slightly smaller than on the pervious examination with the length of the right lobe in the mid clavicular line now measuring 16.2 cm. There is no evidence of intra or extrahepatic bile duct ectrasia and the gallbladder appears normal. The liver texture remains abnormal with moderate decrease in the visualization of the peripheral portal venous vasculature which is a nonspecific finding which could be associated with a chronic inflammatory process or deposition of dense material such as fat or fibrous tissue. The spleen is not enlarged measuring 9.9 cm in length. There was no evidence of ascites. The hepatic artery, hepatic veins, portal vein, splenic vein and IVC were examined with duplex color Doppler ultrasound and appropriate antegrade flow was observed in all of the vessels insonated. Impression: Chronic hepatic inflammatory process vs deposition of dense material
such as fat or fibrous tissue. No Doppler evidence of portal hypertension or Budd-Chiari
syndrome. Following intravenous administration of 28.3 mci of technetium 99m MDP, whole
body bone images were performed. IMPRESSION, Degeneration changes in both feet as described above. Surgical Pathology Report Fifty-one year old white male with abdominal pain and constipation. Hepatomegaly. The specimen is labeled "DESCENDING COLON POLYP" and it is received in formalin. It consists of several fragments of soft pink-tan tissue ranging from 1 mm up to 3 mm in maximum dimensions. SUBMITTED IN TOTO CAP A1. Diagnosis: DESCENDING COLON POLYP: TWO COLONIC BIOPSIES WITH SLIGHT HYPEREMIA AND INCREASED PROPARIAL CELLULARITY, TWO SMALL FRAGMENTS WITH SEVERE ARTIFACT WITH FEATURES OF POSSIBLE HYPERPLASTIC POLYP. T67600, M76800, P11400, M36110, M09030, M72040 BH NAYERE ZAERI, M.D.. _______________________ 01/12/96 (Electronic Signature) Print Date/Time 01/13/96 0134 Page Number: 1 Surgical Pathology Report Date of Surgery: 02/01/96 Accession: SP-96-00681 None given. Macroscopic Description: The specimen is labeled "LIVER BIOPSY" and consists of a wedge of liver tissue that measures 2.5 x 0.5 cm in maximum extent. The capsular surface appears to be smooth and glistening. TWO SECTIONS SUBMITTED IN ONE CAP. Subsequent received is a specimen labeled "GALLBLADDER" and received in formalin. It consists of a collapsed gallbladder and measures 6.0 x 3.2 x 1.5 cm. The surface is smooth. The lumen contains a small amount of bile. The mucosa is congestive. The wall averages 0.5 cm. REPRESENTATIVE SECTIONS SUBMITTED IN CAP B1. mb/bh N. ZAERI, M.D. Microscopic Description: The open wedge biopsy of liver shows generally preserved acinar architecture. Portal areas are essentially devoid of any significant inflammatory infiltrate except for a single portal area with a rather dense lymphoplasmacytic infiltrate blurring the limiting plate and the portal components. Also noted is focal steatosis adjacent to this infiltrate. The remaining parenchyma shows scattered large nuclei, double nucleated hepatocytes indicative of some regenerating activity. The overall histopathologic findings of liver is essentially similar to the previous biopsy (7/5/95). The exact nature of this focal lympho- plasmacytic infiltrate is not clear, and no specific diagnosis can be offered based on histology alone. Diagnosis: LIVER WEDGE BIOPSY: FOCAL PORTAL LYMPHOPLASMACYTIC INFILTRATE AND STEATOSIS WITH SOME REGENERATING ACTIVITY THROUGHOUT. NO SPECIFIC DIAGNOSIS CAN BE MADE. CLINICAL CORRELATION IS ADVISABLE. CHRONIC CHOLECYSTITIS. Report on Lyme Disease Negative.
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