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Gut 2007;56:1336; doi:10.1136/gut.2006.104893
Copyright © 2007 BMJ Publishing Group Ltd & British Society of Gastroenterology.

EDITOR'S QUIZ: GI SNAPSHOT

Multiple liver lesions in a smoker

J Sharkey1, K R Palmer1, I D R Arnott1, S Glancy2

1 Gastrointestinal Unit, Western General Hospital, Edinburgh, UK
2 Department of Radiology, Western General Hospital, Edinburgh, UK

Correspondence to:
Correspondence to:
Ian D R Arnott
Gastrointestinal Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK; ian.arnott@luht.scot.nhs.uk

Received 7 July 2006
The first 150 words of the full text of this article appear below.

Clinical presentation

A 39-year-old female smoker presented to the gastrointestinal unit with a 6-month history of increasing right upper quadrant pain, abdominal distension, nausea and anorexia. There was a history of dysmenorrhoea but no bowel disturbance. There was no medical history of note.

On examination, the abdomen was distended with right upper quadrant tenderness. Investigations showed a normal full blood count and normal renal and liver biochemistry. Inflammatory and tumour markers were not elevated. An abdominal ultrasound identified an enlarged liver with coarse echo texture and several focal abnormalities throughout both lobes. A CT scan of the abdomen showed multiple indeterminate areas of low attenuation within the liver (figure 1Go). MRI of the liver (figures 2Go, 3Go) provided further characterisation.


 


 


 

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What is the diagnosis and what further investigation and follow-up . . . [Full text of this article]


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EDITOR’S QUIZ: GI SNAPSHOT
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