Nodules of calcification within the liver

　　What are the causes of intraparenchymal calcifications?

　　①Intraparenchymal bile duct stones, which are the most common factor;

　　②Chronic inflammation or trauma in the liver;

　　③Parasitic infection;

　　④Calcification of benign and malignant tumors and intraparenchymal metastases in the liver;

　　⑤Congenital development, the fetus in the uterus has the formation of intraparenchymal calcifications, often accompanied by congenital malformations, with a detection rate of 0.057%.

　　If intraparenchymal calcifications are not paid attention to and treated, they can develop into liver cirrhosis, leading to complications such as bleeding, ascites, liver cancer, and other life-threatening conditions. Mild fatty liver does not require medication and can be treated with dietary adjustment and increased exercise. However, moderate and severe fatty liver requires medication. Calcifications do not require treatment unless they are too large.

　　During the process of calcification formation, intraparenchymal calcifications may appear:

　　Epigastric pain, which may be typical biliary colic or persistent distension pain, with some patients having no obvious pain but severe chills and fever, with periodic attacks;

　　During the examination, there is marked tenderness and percussion pain in the liver area, with asymmetrical enlargement of the liver and tenderness.

　　Prevention of the occurrence of intraparenchymal bile duct stones: Adjust diet, reduce cholesterol intake, eat more high-protein foods, vegetables, and fresh fruits. In addition, appropriate physical exercise should be carried out regularly to prevent excessive accumulation of fat in the body.

　　At the same time, it is necessary to actively and effectively control biliary tract infections.

　　Similar strong echoes or high-density images like stones appear in the liver on B-ultrasound or CT images.

　　High CT resolution shows clear calcification, mainly used for B-ultrasound difficulty in distinguishing intraparenchymal calcifications, especially when there is a suspicion of intraparenchymal metastases. Most intraparenchymal calcifications are found incidentally during routine physical examinations. For solitary or multiple isolated calcifications without fusion in the liver, without any自觉 symptoms and signs, and with no abnormalities in liver size and shape, they may be related to factors such as congenital development, malnutrition, disorders of calcium and phosphorus metabolism, or injury. They may also be related to certain diseases, such as intraparenchymal bile duct stones, liver abscess, or changes after liver trauma healing. The B-ultrasound image characteristics of this type of intraparenchymal calcification are: scattered strong echoes in the shape of a 'crane's foot' or an 'equals sign', extending outside the bile duct lumen, with most having no shadow or faint shadow at the back, and no intraparenchymal bile duct dilation. There is no need for treatment for this type of intraparenchymal calcification. For caution, follow-up observation can be carried out for up to 2-3 years, with B-ultrasound examination every 3-6 months.

　　Suitable foods for patients with intrahepatic calcification foci: staple foods containing starch such as grains and various fruits, honey, etc., which can provide sugar, supplement daily needed calories, and enhance the detoxification function of the liver. Foods such as sesame, peanuts, soybeans, rapeseed, corn, sunflower seeds, coconuts, and vegetable oils, egg yolks, milk, etc., can provide fatty acids for hepatitis patients, supplement calories, and help the absorption of fat-soluble vitamins. Fish, shrimp, shellfish, lean meats of cattle, sheep, and pigs, poultry eggs, etc., can provide protein-rich foods, which can promote the repair and regeneration of liver cells, supplement metabolic consumption of the body, and provide a certain amount of calories.

　　Unsuitable foods for patients with intrahepatic calcification foci: alcohol, spicy foods such as ginger, scallions, chili, greasy fried foods, hard, spiky, or bony meats, and vegetables with too much plant fiber.

　　For patients without intrahepatic bile duct dilatation of this kind, no treatment is needed. For prudence, such calcification foci can be followed up and observed for 2 to 3 years, with B-ultrasound examination every 3 to 6 months.

　　For the treatment of intrahepatic bile duct dilatation, surgical treatment is still the main method at present, with good efficacy.

　　Principles of Surgical Treatment:

　　① Try to remove all the stones and relieve the stenosis of the bile duct;

　　② Based on the correction of bile duct stenosis and the relief of obstruction, a biliary-enteric drainage operation is performed to expand the outflow tract of the bile duct;

　　③ If the lesion is limited to the left lobe of the liver, a lobectomy can be performed to completely treat the condition.

　　Surgical Methods:Generally, a high-positioned bile duct incision is used to remove stones. It is best to extend the incision of the common bile duct to the confluence of the hepatic ducts, and thoroughly remove the stones in each branch under direct vision through the openings of the right and left hepatic ducts. At the same time, the narrow intrahepatic bile ducts are incised. For stones located in the superficial part of the liver, the intrahepatic bile duct is incised through the liver parenchyma, the stones are removed, and a T-tube or biliary-enteric drainage operation is performed.