Q. I have pain in upper right abdomen with grade 1 fatty liver and vitamin B12 deficiency. Please help.

Answered by
Dr. Vivek Chail
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 24, 2020

Hello doctor,

I have pain in the upper right abdomen. The pain goes to the back and side especially when I sleep on the side. Sometimes the discomfort is in the middle right and lower abdomen. I have taken a CT scan of the abdomen and pelvis with iv contrast. I had an ultrasound done a few months ago which revealed grade 1 fatty liver. I feel tired all the time. I have gained 3 kg within four months. I also get frequent leg pain and weakness especially in the morning when I wake up. I had vitamin B12 deficiency and have taken 15 injections before three months. I have a lot of gastric issues with this as well. I am uploading my CT images. Please help.

Dr. Vivek Chail

Radiodiagnosis Radiology


Welcome to icliniq.com.

I have seen the attachment. (attachment removed to protect patient identity).

The CT abdomen scan is showing mild fatty changes in the liver and a left inguinal hernia. The ultrasound scan abdomen is showing fatty changes in the liver. The upper gastrointestinal endoscopy report is showing a small hiatus hernia. The blood test is showing upper limit of normal SGPT (serum glutamic pyruvate transaminase) and SGOT (serum glutamic oxaloacetic transaminase). The contrast CT scan images of the abdomen are viewed.

The fatty changes in the liver are not significant. Such fatty changes are visualized in many people. However, if you are having a high-fat diet or alcohol regularly then you need to discuss with your doctors and take precautions.

The hiatus hernia is a small herniation of the stomach above the diaphragm. This causes discomfort on bending down. Please avoid bending frequently, avoid lying down for two to three hours after a meal. Avoid smoking. Take meals in small amounts, if you feel discomfort when eating too much.

For the left inguinal hernia, you need to consult a surgeon and take an opinion. It might need surgery and repair.

Coming to the pain, it is possible that the hernia can cause pain in the lower abdomen. At the same time, other causes of weakness need to be discussed. It will help to know if you got a complete blood test done (other than given liver tests and vitamin B12 test) and if there are other areas that need attention.

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