Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Distended abdomen, fatty liver, enlarged spleen and left renal fullness?Hi everyone!Just wondering if anyone has any ideas as even my GP seems to be stumped!I'm female, 32, MODY diabetes on insulin and high blood pressure (on nifedipine). Have a history of colon polyps but most recent colonoscopy in June was clear.The last few months I've been struggling with swelling in my stomach (photo) I look heavily pregnant and it is so uncomfortable, and the few weeks I've started having pain around my right rib area and into my back. Also have extreme fatigue.2 different GPs examined me and both were certain it was fluid so referred me for ultrasounds.I had these last week and had the results today - there is no fluid! The ultrasound did confirm moderate fatty liver, an enlarged spleen and left renal fullness.GP has referred me to haematology to look into the spleen, but said the fatty liver is only moderate and wouldn't cause the pain etc. He also doesn't know what the left renal fullness means but I do have a repeat enal ultrasound tomorrow.Full blood count was normal, kidney function came back normal but GFR had dropped from 85 in April to 62 last week, ALT on liver function only slightly raised to 62, cholesteral high at 6.3 with triglycerides at 7.3mmol.Anybody have any ideas at all as to what could be causing the swelling etc?Thanks - sorry it was such a long post!. ### Response: An ultrasound cant tell the difference between fat and fibrosis. Your labs and imaging findings of enlarged spleen are concerning for possible liver disease. You should see a gastroenterologist for further work up..