65-Year-Old's Liver Packed With Tumors After Month of Diarrhea
A 65-year-old HBV carrier arrived at hospital with a month of diarrhea and was found to have his liver packed with tumors, a condition he could have detected earlier with regular screening.
A 65-year-old man presented to hospital in early July with over a month of continuous diarrhea, coming in only after finishing a construction job elsewhere. During the physical examination before ultrasound, emergency medicine physician Dr. Bei Qili immediately noticed alarming signs: the upper abdomen was visibly bulging and abnormally hard to palpation—findings that prompted deep concern even before imaging. Ultrasound confirmed that the liver was filled with tumor nodules.
History-taking revealed the patient was an HBV carrier but had never received regular monitoring. He admitted the abdominal swelling had been present for 1-2 months; he had only intended to visit the clinic during a break to collect medication, but the diagnostic results came as a shock.
Dr. Bei Qili explained that being an HBV carrier does not necessarily lead directly to cirrhosis. Most carriers, if the virus is in a low-activity phase and liver function remains consistently normal, can coexist with the virus throughout life and may not require treatment. However, key factors that worsen disease include ongoing viral activity, chronic liver inflammation, and additional risk factors such as advanced age, alcohol consumption, fatty liver, or diabetes.
Scientific studies show that among patients with chronic hepatitis B with active viral replication and inflammation, approximately 15-20% develop cirrhotic scarring within 15-20 years due to repeated liver damage and repair cycles, eventually progressing to end-stage cirrhosis.
Dr. Bei Qili warned that HBV carriers—even those without symptoms and with normal liver function on blood tests—must undergo regular monitoring. Most patients should visit a gastroenterology or hepatology clinic every 6-12 months. High-risk groups, such as those with cirrhosis, high viral load, family history of liver cancer, or those undergoing treatment, should be checked every 6 months or more frequently at the physician's discretion.
The doctor stressed that comprehensive monitoring is essential and should not be neglected. Beyond blood tests assessing liver function (ALT and AST) and alpha-fetoprotein (AFP), abdominal ultrasound is mandatory. Blood work evaluates inflammation, AFP is only a supporting marker, while abdominal ultrasound is the most important screening tool for cirrhosis, liver nodules, and early-stage hepatocellular carcinoma.
