Download FREE Practo app
Get ₹200 HealthCash
CLD and Jaundice
1 month back my father had fever which continued for 10-12 days. In between of this he checked LFT ,bilirubin was 2.5 after having few medicines it came back to 0.53. His gallbladder stone was diagnosed of 7 mm 7 years back. He was fine for 20 days, again he got fever and yellow eyes on 14 July. His bilirubin was 8, direct was 7.2 indirect 0.8. Now fever comes and goes. He went through MRCP, it shows Chronic lever disease. He never drink or smoke. What caused this? He is diabetic for 30 years and have bp. I'm attaching his mrcp report and today's lft report. Please suggest me what to do next, I'm very much stressed and worried 🙏
Should we get his gallbladder removed if that's causing biliary obstruction?
Answers (3)
Get your queries answered instantly with Care AI FREE
20000+ health queries resolved in last month
Trilogy of chronic liver disease needs to be evaluated
There is a small lesion in liver which needs further investigation
Next Steps
Physical consultation for work up of CLD and evaluation of liver SOL
Health Tips
Gb surgery would not help in bilirubin of chronic liver disease rather it may further decompensate or progress the disease as surgery is an acute stress event
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
+176
Ms. Promila Goyal
Gastroenterologist
12 yrs exp
Bathinda
Based on the history and reports, this appears more consistent with chronic liver disease (CLD) with portal hypertension, associated gallstone disease (calculous cholecystitis), and recurrent episodes of obstructive jaundice/cholangitis. The MRCP does not show dilatation of the bile ducts or a CBD stone at present, so the jaundice may not be due to persistent biliary obstruction alone. Diabetes-related metabolic liver disease (MASLD/NASH), previous infections, viral hepatitis, autoimmune liver disease, or other chronic liver disorders should also be evaluated as possible underlying causes.
Gallbladder removal should not be decided solely on the basis of gallstones. Because there is evidence of portal hypertension, splenomegaly, and collateral vessels, cholecystectomy carries a higher surgical risk and should be planned only after evaluation by a hepatologist and an experienced hepatobiliary surgeon.
Next Steps
* Urgent consultation with a hepatologist/gastroenterologist.
* Complete CLD work-up: viral hepatitis markers (HBV/HCV), autoimmune liver profile, iron studies, ceruloplasmin (if indicated), and metabolic evaluation.
* Triple-phase CT liver (as advised in the MRI report) and serum AFP to characterize the liver lesion.
* Upper GI endoscopy to screen for esophageal varices because of portal hypertension.
* Monitor liver function tests, INR/PT, CBC, and renal function.
* If fever, jaundice, or abdominal pain persists, hospital admission is warranted to rule out acute cholangitis, which may require IV antibiotics and urgent biliary intervention.
Health Tips
Although the situation is serious, it is treatable. The priority is to identify the underlying cause of the chronic liver disease and stabilize liver function before considering gallbladder surgery.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Siddiraju Venkatakapilkishore
Laparoscopic Surgeon
16 yrs exp
Bangalore
Hello Madam,
Your father’s recurrent fever and jaundice require urgent evaluation.
Although he has a history of a 7 mm gallstone, the MRCP does not show any bile duct stone or biliary obstruction.
Instead, it shows multiple gallstones with acute calculous cholecystitis, along with chronic liver disease, portal hypertension (splenomegaly and collateral vessels), and a nodular liver.
His LFTs show persistent direct hyperbilirubinemia (Total bilirubin 3.71 mg/dL, Direct 2.06 mg/dL) with elevated ALP, indicating ongoing liver/biliary disease.
The chronic liver disease is unlikely to be caused by gallstones alone.
Given his 30-year history of diabetes, MASLD (fatty liver disease) is a likely cause, although viral, autoimmune, and other liver diseases must be excluded.
Next Steps
He should be urgently seen & evaluated by Hepatologist and/or Gastro-surgeon or HPB Surgeon.
He requires some blood tests to assess severity of the clinical condition like (Child-Pugh/MELD).
If acute cholecystitis is confirmed, IV antibiotics should be started.
Gallbladder removal should not be performed immediately
Gall Bladder surgery should be considered only after the infection is controlled and the chronic liver disease has been fully assessed and optimized.
Health Tips
Do not delay treatment.
Recurrent fever with jaundice in a patient with chronic liver disease and diabetes can rapidly progress to sepsis or liver decompensation.
Seek emergency care immediately if he develops persistent fever, worsening jaundice, confusion, abdominal swelling, vomiting blood, black stools, or severe abdominal pain.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Articles you may like
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
The question asked on this page is a free question. You can ask a free health question by downloading the Practo app.
Articles you may like
Tell us what's troubling you
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.