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The accuracy and clinical significance of sonography (US) in demonstrating fatty liver and hepatic fibrosis in chronic hepatitis C (CHC) are rarely reported. US had sensitivity 71.1%, specificity 72.9%, 58.7% positive predictive value (PPV), and 82.3% negative predictive value (NPV) in demonstrating histological steatosis > or =5%. US had sensitivity 85.7%, specificity 60.4%, 13% PPV, and 98.4% NPV in demonstrating histological steatosis > or =30% with clinical significance in predicting prognosis and therapeutic response in CHC. Subjects with fatty liver on US had a greater prevalence of body mass index (BMI) > or =25 kg/m2, inflammation-necrosis grade >2, and total bilirubin

Alpha-fetoprotein is often measured in subjects with chronic hepatitis C for diagnosing hepatocellular carcinoma. However, its prevalence and clinical significance remain inconclusive in subjects without hepatocellular carcinoma. The study was to assess the clinical, virologic, and histopathological significance of elevated AFP in chronic hepatitis C without the presence of hepatocellular carcinoma.The retrospective study enrolled 102 consecutive subjects with a histological diagnosis of chronic hepatitis C. None had evidence of hepatocellular carcinoma by image study at enrollment and for at least 6 months' follow-up. The correlation between serum alpha-fetoprotein level and clinical, virologic, or histopathological records was reviewed.The prevalence of elevated serum alpha-fetoprotein (or = 13.6 ug/L) was 28.4% (29/102) in this study. Hepatic steatosis (or = 5% hepatocytes), hepatic fibrosis (or = stage II), uric acidor = 6.3 mg/dL, asparate aminotransferaseor = 40 IU/L, albumin3.5 g/dL, and fasting plasma glucose126 mg/dL were significantly associated with elevated AFP in multivariate analysis. However, neither hepatitis C virus genotype Ib infection nor viral loador = 1x10(6) copies/ml was related to elevated AFP. A serum alpha-fetoprotein level of 15.6 ug/L was 34.3% sensitive and 83.6% specific for hepatic steatosis, was 28.2% sensitive and 95.8% specific foror = stage II hepatic fibrosis in Chronic hepatitis C.Elevated alpha-fetoprotein is independently associated with hepatic steatosis (or = 5% hepatocytes),or = stage II hepatic fibrosis, increased level of uric acid (or = 6.3 mg/dL) or asparate aminotransferase (or = 40 IU/L), and decreased level of albumin (3.5 g/dL) or fasting plasma glucose (126 mg/ dL). Viral factors, including hepatitis C virus genotype 1b infection and viral load, are not related to elevated alpha-fetoprotein in hepatitis C virus-infected subjects.

Background Mucoceles resulting from cystadenomas of the appendix are uncommon. Although rare, rupture of the mucoceles can occur with or without causing any abdominal complaint. There are several reports associating colonic malignancy with cystadenomas of the appendix. Herein, we report an unusual and interesting case of right inguinal hernia associated with left colon cancer. Case presentation A case of ruptured mucocele resulting from cystadenoma of the appendix was presented as right inguinal hernia in a 70-year-old male. The patient underwent colonoscopy, x-ray, ultrasound and computed tomography. Localized pseudomyxoma peritonei associated with adenocarcinoma of the descending colon was diagnosed. The patient underwent segmental resection of the colon, appendectomy, debridement of pseudomyxoma and closure of the internal ring of right inguinal canal. He is free of symptoms in one year follow-up. Conclusion Synchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated and colonoscopy can be performed meticulously in cases of ruptured mucoceles and localized pseudomyxoma peritonei. Surgical intervention is the current choice of management.