C09990460 / invoice 10000

05/03/2026 No obvious mass on CT - ddx tumour vs infection
Options: US guided FNA liver
Amoxyclav and recheck on Monday (recheck + liver enzymes)

05/03/2026 NURSE: EL/MY

SEDATION: 
Medetomidine: 0.25ml IM 

PROCEDURE: 
Ultrasound guided liver aspirates completed. Attempted splenic LN aspirate, but was too deep to achieve. 
Alfaxan: 0.4ml given IV given for further sedation

REVERSAL:
Antipam: 0.25ml given IM postop

PLAN: 
Await patholgy results
TGH Amoxyclav 625mg BID 
RV booked for Tuesday

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Abdominal Ultrasound
Liver/biliary system – Diffuse, finely heterogeneous change. Within this background change
there is some rounding of the caudate lobe and suggestion of a mass within this lobe (lobar mass)
Kidneys – NAD
Adrenals - both approx 5mm
Spleen - NAD
Pancreas - no obvious abnormality noted
GIT – No focal or diffuse wall thickening noted and no obstructive pattern seen
Bladder/pelvic area - No obvious abnormality noted. No focal or diffuse wall thickening noted
and no intraluminal problem seen
LN/great vessels - no obvious abnormality noted
No excess peritoneal fluid seen
Assessment
Diffuse and non-specific liver changes. Today there is some lobar rounding of the caudate lobe.
One possibility here is a lobar mass
5th March addendum
FNAB of caudate / enlarged liver lobe taken
Enlarged splenic LN also noted (heterogeneous, mildly nodular but with a normal hilar region
noted)