Can anyone make sense of these CT findings?

My fiance can’t reach his doc and is in horrible pain. We went to the ER last night and the doc said his CT scan was normal (we thought he had gall stones). We got a copy of the CT scan today and the findings are…
Focal Fatty Infiltration of the liver (doesn’t drink)
Shotty retroperitoneal adenopathy
Mesenteric adenopathy in RT. lower quad.
mild dependent peripheal interstitual densities, which represents atelectasis
Atelectasis within the lingula as well
Small splenule in left upper Quad of spleen.

Focal fatty infiltration isn’t caused purely by drink, diet can be a contributing factor, and it’s incidence is ever increasing. It’s often an incidental finding and if the radiologist isn’t overly concerned by it’s appearance, then that should be satisfactory. It could be causing the acute pain, but it depends on the severity of the fatty infiltration. Where exactly is his pain?

Ateclectasis is something that i would have felt would have warranted at least an investigation. Is his breathing particulalrly shallow? It can lead to pneumonia which would account for many of his symptoms, including the sweats and severe fatigue, but i would expect more chest symptoms.

As for the lymphadenopathy, the cuases of this are vast. If there had been suspicion of gall stones, it could be that this and the abdominal pain and other symptoms are being caused by acute cholangitis (infection of the bile ducts). Does he have any other symptoms, maybe itching, pale stools, darker urine? Does he have any bowel symptoms?The retroperitoneal lymphadenopathy does cause more concern, but again, the causes can be numerous.

If the sweats and fatigue are now since the abdominal pain, i would return to the ER and ask for them to investigate further, or speak to your family doctor to get him admitted.

Have they run all blood tests on him, including HIV?

Laparoscopic liver surgery at UPMC

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