I did a CECT scan for abdominal pain. Are my reports normal?

Hello,

Welcome to icliniq.com.

I understand your concern.

I have read your query and reviewed your reports (the attachments have been removed to protect the patient's identity).

Your complaint of upper abdominal pain combined with a CECT (contrast-enhanced computed tomography) scan and a significantly elevated CA (cancer antigen) 19-9 level (724 U/mL (units per milliliter)) in the context of chronic hepatitis B and current antiviral therapy (Durataf 25, a form of Tenofovir) raises concern and requires careful evaluation.

CA 19-9 is a tumor marker often associated with pancreaticobiliary malignancies, but can also be elevated in benign conditions like cholangitis, cirrhosis, or obstructive jaundice, especially in the presence of chronic liver disease such as hepatitis B.

The key next step is to closely examine the CECT scan findings, specifically for any mass lesions in the pancreas, bile ducts, or liver, as well as signs of biliary obstruction or lymphadenopathy.

Your CECT scan shows the following:

1. Enlarged liver with diffuse altered texture, irregular surface, enlarged caudate lobe, and altered right-to-left lobe ratio; these features are all suggestive of chronic liver disease. Liver capsule is normal with no bile duct or IHBR (intrahepatic biliary radicles) dilatation.

2. The portal vein is dilated (approximately 15 millimeters) with dilated splenic and superior mesenteric veins and a few porto-systemic collaterals suggestive of portal hypertension.

3. Mildly over-distended gallbladder with diffuse wall edema and sludge inside.

4. Mildly bulky pancreas with heterogeneous texture and areas of non-enhancement (30 to 50 percent), peripancreatic edema and fluid tracking, features suggestive of pancreatitis (likely acute on chronic). Pancreatic duct not dilated. Pancreatic calcifications are present.

5. The stomach shows a mild diffuse wall thickening and edema.

6. Other abdominal organs are largely normal, with no ascites or masses seen.

If the scan shows suspicious lesions or ductal dilation, you will be suggested other tests like:

1. MRI (magnetic resonance imaging) or MRCP (magnetic resonance cholangiopancreatography).

2. An endoscopic ultrasound (EUS) may be warranted.

3. Liver function tests.

4. AFP (alpha-fetoprotein-non-pregnant) levels to screen for hepatocellular carcinoma.

5. Viral load monitoring should be part of ongoing care.

Please follow up with your hepatologist or gastroenterologist urgently, as further workup, including possible biopsy or advanced imaging, may be needed depending on what the CECT shows.

Early intervention is critical if a malignancy is suspected.

I hope this helps.

Thank you.