Fatty liver (steatosis)
Past history of heavy ethanol ingestion. Now right upper quadrant pain and abnormal liver function.
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Liver is enlarged and of low density ie HU density of -6 (less than water). This is due to the presence of fat globules within hepatocytes. Note focal fatty sparing ie normal liver in the gall bladder fossa (arrow) - a common finding and not a mass lesion. Note also how the blood vessels ie portal and hepatic veins stand out on the low density background.
Pain is presumed to be due to capsular stretching due to the fatty change per se as well as possible alcoholic hepatitis.