<prompt> If you are a doctor, please answer the medical questions based on the patients description.Hi Doctor I was having pain in upper right abdomen since 4 days. I went for ultra sound and below is the report: Liver is enlarged in size 16.94cm. Outline is normal. There is a diffuse increase in echotexture suggestive of fatty change, grade 1. No focal lesion is seen. Portal vein and hepatic vein are normal. Intrahepatic biliary radicals are not dilated. GB is distended with anechoic lumen. Wall thickness is normal. CBD caliber is normal. Pancreas is normal in size, outline and echotexture. Spleen is normal in size 11.15cm, outline and echotexture. No focal lession is seen. Both kidneys are normal in size Rt 10.97cm Lt. 10.99cm, outline echotexture. Cortico-medullary diffrentiation is maintained. No pelvicalyceal dilatationcalculus seen. No retroperitoneal lymphadenopathy free fluid is seen. Please correlate clinically.  <response>: Hello Mr. Nikhil, I have gone through your ultrasound report. You have mentioned that you are having right upper abdomen pain since 4 days and ultrasound showing enlarged liver with grade 1 fatty changes. Well, the liver has a capsule over it. So when the liver enlarges hepatomegaly the capsule stretches and this causes pain in the right upper abdomen region. Fatty changes in the liver is seen in many patients like alcoholics and also obese patients. Grade 1 fatty changes is not a big issue. You have not mentioned any other symptoms you might be having and your personal habits like alcohol intake. If you are having fever, jaundice and right upper abdomen pain, you might be having hepatitis. For that you need to get your liver function tests LFT. Usually in such cases LFT may show elevated levels of SGPT and GOT. If your fatty changes are due to alcohol intake, then you need to give up that habit and eventually the fatty changes will revert to normal. My advice is to consult a physician immediately and get a Liver function test done. Further management depends on your LFT report. 