<s>[INST] Clinical history - Epigastric and right sided abdominal pain. Reduced appetite. Raised ALT I recently had an US scan and the report says that the liver is slightly enlarged echogenic consistent with fatty infiltration. There is a 2.1 cm hypo echoic area of liver parenchyma adjacent to the gallbladder, appearances are likely to represent focal fatty sparing. Normal direction portal vein flow. Normal appearance of the right kidney. The left Kidney demonstrates mild fullness of the pelvicaliceal  system. No renal calculi demonstrated. Normal appearance of the gall bladder, biliary tree, spleen and abdominal aorta. Normal appearance of the pancreas head and body, the pancreas tail was obscured by overlying bowel gas.Comment - Mild fullness of the pelvicaliceal  system in the left kidney - whilst unrelated to the presenting symptoms and may be nothing, suggest this cannot be ignored and referral for CT KUB is advised. [/INST] Hi, dairy have gone through your question. I can understand your concern. You have fatty liver.  It leads to increase in liver enzymes level.  You should go for regular exercise.  Avoid fatty food, alcohol and smoking.  Adílio like Chat Doctor.  Your ultrasound study also suggests fullness inlet kidney area.  There can be some pathology, and you should go for ct scan of kidney, ureter and bladder. Your rest of the reports like gall bladder, aorta, pancreas all are normal. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>