Subjective
Date of visit
Reason for visit (initial evaluation for suspected polycystic liver disease (PLD), follow-up for known PLD)
History of present illness:
Symptoms (may be absent in early stages):
Abdominal pain or discomfort (especially in the upper right quadrant)
Early satiety (feeling full after eating a small amount)
Nausea or vomiting
Fatigue
Jaundice (yellowing of the skin and eyes – uncommon)
Family history of PLD (important as it’s a hereditary condition)
Past medical history (relevant conditions)
Medications (current medications)
Allergies
Objective
Vital signs (temperature, heart rate, blood pressure) – usually normal unless complications arise
Physical exam:
General (assessing for signs of chronic liver disease)
Abdominal exam:
Palpation (enlarged, firm liver – hepatomegaly)
Percussion (possible dullness to percussion over the liver)
Signs of portal hypertension (enlarged spleen, ascites – fluid accumulation in the abdomen) may be present in advanced cases.
Assessment
Suspected polycystic liver disease based on clinical presentation and family history (if positive)
Diagnostic workup (may include some of the following):
Imaging studies:
Ultrasound (initial imaging modality to detect cysts)
CT scan or MRI (may provide more detailed information about cyst size and location)
Liver function tests (LFTs) – may be normal or show mild abnormalities
Consideration of alternative diagnoses (other liver diseases with similar presentations)
Plan
Definitive diagnosis based on imaging studies
Treatment (aimed at managing symptoms and preventing complications):
Pain management (medications, lifestyle modifications)
Ursodeoxycholic acid (medication to improve bile flow) – may be helpful for some patients
Liver transplantation (considered for severe cases with complications)
Monitoring for complications of PLD (portal hypertension, liver failure)
Education
Explain polycystic liver disease, its hereditary nature, and the potential for variable symptoms.
Discuss the importance of regular monitoring and management of symptoms.
Provide information on healthy lifestyle practices to support liver health.
Follow-up
Schedule for follow-up appointments:
Monitor for symptom progression and complications
Repeat imaging studies periodically to assess cyst growth
Consider referral to a hepatologist (liver specialist) for complex cases or complications
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of polycystic liver disease.