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A fourteen year old boy who had sickle cell anemia developed symptoms of hepatic encephalopathy which indicated decompensated liver disease due to fatty liver after exclusion of other causes of liver cirrhosis . A liver biopsy to assess the stages of the disease and histological changes of steatosis was not carried out in any patient enrolled in the study symptoms of nonalcoholic fatty liver diseasee because of the risks associated with biopsy. In addition, the histological findings do not contribute to the symptoms of nonalcoholic fatty liver diseasee future management. Conclusion Overweight and obesity are risk symptoms of nonalcoholic fatty liver diseasee factors for a fatty liver in Saudi Arabia, which is more prevalent in females. Ultrasound appears to be a useful non-invasive tool to determine liver involvement with fatty liver in obese adults even in absence of hypertransaminasemia.
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