Revista chilena de cirugía
versión On-line ISSN 0718-4026
CSENDES, ATTILA; SMOK, GLADYS; BURGOS, ANA MARIA y CSENDES, PAULA. Liver ultrasound and pathology in 414 morbid obese patients. Rev Chil Cir [online]. 2006, vol.58, n.3, pp. 187-193. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262006000300005.
Background: Non alcoholic steatohepatitis is common among patients with morbid obesity. Aim: To assess the prevalence of pathological alterations in the liver in patients with morbid obesity. Material and methods: Prospective study of patients with morbid obesity subjected to bariatric surgery. In the preoperative period serum lipid levels were measured and an abdominal ultrasound was performed in 342. During surgery a liver biopsy was obtained. Results: The pathological study of the liver showed a normal liver in 41 patients (10%), mild steatosis in 130 (31%), moderate steatosis in 59 (14%), severe steatosis in 32 (8%), steatohepatitis in 88 (21%), steatohepatitis with fibrosis in 60 (14%) and cirrhosis in 4 (1%). No association between liver damage and gender, body mass index or serum lipid levels, was observed. The liver was informed as normal on ultrasound examination in 47 of 106 (44%) patients with mild steatosis on pathology. On the other hand, liver was informed as having steatosis on ultrasound in 11 of 23 (32%) patients with pathologically normal liver. The concordance between ultrasound and liver pathology among patients with moderate or severe steatosis was 82 and 96%, respectively. Conclusions: Ninety percent of patients with morbid obesity have liver damage on pathology. Among patients with moderate or severe steatosis, there is a good concordance between ultrasound and pathological findings
Palabras llave : Morbid obesity; liver biopsy; non alcoholic steatohepatitis.