Hai visited Tam Anh General Hospital, Ho Chi Minh City, because his liver enzyme levels had been consistently and unusually high for the past two months. He weighed 132 kg, suffering from severe obesity with a body mass index (BMI) of 41, a waist circumference of 150 cm, high blood pressure, and pre-diabetes. An ultrasound revealed a 7 mm calcified nodule in the right lower liver lobe.

Dr. Lam Van Hoang, Head of the Endocrinology - Diabetes Department, stated that prolonged accumulation of excess fat in Hai's case promoted inflammation and metabolic disorders, leading to chronic fatty liver, elevated liver enzymes, and liver damage.

Doctors performing an ultrasound on Hai discovered fatty liver and liver calcification. *Photo: Tam Anh General Hospital*

A calcified nodule in the liver indicates liver calcification, a dangerous chronic liver injury that causes scarring. According to Dr. Hoang, these nodules can appear due to various reasons, including hepatitis, medication use, or prolonged fatty liver, excessive alcohol consumption, stimulants, and liver dysfunction.

The doctor instructed Hai to lose weight to reduce the fat accumulation in his liver and prevent the calcified nodule from growing. The patient was prescribed oral fat-reducing medication and injectable obesity medication to decrease hunger and limit calorie intake, while also abstaining from alcohol.

A nutritionist advised Hai on a liver-protective diet, emphasizing increased consumption of green vegetables and fruits. He was encouraged to prioritize white meats like fish or chicken, limit high-cholesterol foods such as organ meats and red meats, and drink sufficient water. The patient also needed to adjust his lifestyle by avoiding late-night eating, not overeating, and getting enough sleep, all of which help reduce the burden on the liver and support its detoxification functions. In the initial days of treatment, Hai transitioned to 0% alcohol beer to gradually quit drinking, made an effort to eat more salads and vegetables, and walked one hour daily.

An exercise medicine specialist guiding Hai on suitable exercises. *Photo: Tam Anh General Hospital*

After two months, he lost 10 kg, and his waist circumference decreased by 10 cm. Ultrasound results showed that the calcified nodule did not increase in size. According to Dr. Hoang, the patient must lose at least 10-15% of his body weight, reaching approximately 100 kg, to significantly improve his fatty liver condition.

Small calcified nodules in the liver that do not cause obvious symptoms typically do not require treatment. However, if calcified nodules grow, they can compress liver tissue and nerves, causing pain during strenuous activity and increasing the risk of cirrhosis. Common symptoms of advanced calcification include high fever, convulsions, jaundice, yellow eyes, and digestive disorders.

Duc Hanh