Browsing by Author "Paranahewa, L."

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    Presence of fatty liver disease leads to unusual rise of liver enzymes in patients with common bile duct colic
    (Korean Association of Hepato-Biliary-Pancreatic Surgery, 2021) Uragoda, B.; Ediriweera, D.; Paranahewa, L.; Ekanayake, C.; Tillakarathna, S.; Siriwardana, R.
    INTRODUCTION: This study compares liver enzymes, inflammatory markers and bilirubin levels in patients with and without fatty liver disease (FLD) presenting with common bile duct (CBD) obstruction. METHODS: CBD colic was diagnosed based on clinical, radiological and biochemical criterion. Presence of FLD was diagnosed by ultra sound scan and the macroscopic appearance of liver during surgery. Liver enzymes, inflammatory markers and bilirubin levels were prospectively assessed and compared between the two groups. RESULTS: Out of 42, there were 22 (52.3%) patients with FLD. Median body mass index was 26.9 (24.1–30.8) in fatty liver group compared to 25.7 (23.5–26.2) in others. Individuals with FLD showed high aspartate transaminase (558.5 vs. 247.0, p = 0.005), alanine trasaminase (467 vs. 228.5, p = 0.005) and bilirubin (3.8 vs. 2.2, p = 0.015) levels compared to those without FLD. According to multiple linear regression models, high AST and ALT levels showed significant associations with FLD after adjusting for age, gender, body mass index, amylase and C reactive protein levels. The median enzyme level at two weeks did not show a difference among patients with and without FLD. CONCLUSIONS:Presence of FLD causes unusual rise of AST and ALT levels in patients with CBD stones. This rise is transient.
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    Unequal distribution of liver fat warrants careful selection of biopsy site during donor assessment
    (Sri Lanka Medical Association, 2017) Siriwardana, R.C.; Sivasundarama, T.; Tillakaratne, M.S.B.; Paranahewa, L.
    INTRODUCTION & OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a major health concern. Liver fat deposition seems to have a segmental variation. This can affect invasive, and non-invasive detection of NAFLD. The present study evaluates the pattern of fat distribution of the liver using liver computed tomogram (CT) attenuation index. METHODS: Two radiologists evaluated 517 non-contrast CT abdomen and pelvis images. Two 40mm2 regions of interest (ROIs) were selected from each segment. The hepatic segmental densities were obtained by calculating the mean densities of areas of corresponding liver segments. The mean hepatic attenuation (MHA) was quantified by obtaining the mean segmental densities. Densities were compared among segments and with the MHA. RESULTS: The median age was 58 years (min-max: 9-88; IQR: 45-67) and 276 (53.4 %) were males. The overall median hepatic density (i.e. grand median) was 53.05 (95% CI 52.95-53.15) Hounsfield units (HU). Lowest median density was observed in segment IVb, significantly lower compared with other segments (p<0.05). Highest median segmental density was observed in segment V compared to other segments (p<0.05). Segments V, VI and VIII had higher median densities compared with grand median hepatic density (i.e. 53.05; whereas median densities of segments II, III and VII were not significantly different from the grand median. CONCLUSION: Liver biopsy taken from segments II, III and VII are likely to be the most representative of overall fat deposition.