So next patient is andrew harrison foxtrot 609923 67 year old man past medical history most recent ogd december 2023 minor reflux esophagitis without attention previous admissions with mild alcohol related hepatitis hypertension anxiety and depression previous barrett's esophagus asymptomatic gallstones in the past medical history 8.3 in mark tretinin 87 electrolytes normal crp 4 lfts bilirubin 26 alt 159 alp normal albumin normal hemoglobin 176 with platelets 129 most recent fibroscan march 2025 5.3 kilopascals iqr / med 15% mrcp march 2025 tiny gallstones but no features of acute cholecystitis or observations respiratory rate 16 sat was 98% on air blood pressure 109 over 83 pulse 80 temperature 37 degrees centigrade so I'll provide the note from the a and e doctor a and e doctor's mentioned alcohol induced liver cirrhosis in the plan in his sorry background however that's not the case he doesn't have alcohol induced liver cirrhosis but he alcohol related liver disease without evidence of fibrosis or cirrhosis on fibroscan