Cardiac cirrhosis. Ascites, liver failure and dialysis. LIVER: The liver is nodular in contour and coarse in echogenicity compatible with cirrhosis. No suspicious lesion is evident. The hepatic veins are enlarged compatible with elevated right-sided heart pressure. The liver measures 16.8 cm in length. Pulsatile hepatopedal portal venous blood flow is noted with a PSV of 0.4 m/s. Perihepatic ascites.BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation with the common duct measuring 6 mm. Normally distended gallbladder without significant gallbladder wall thickening. Echogenic shadowing focus is most compatible with a gallstone.PANCREAS: Suboptimal visualization of the pancreatic head is unremarkable.SPLEEN: The spleen measures 13 cm without a focal lesion.RIGHT KIDNEY: The right kidney is atrophic and echogenic measuring 8.8 cm in length without hydronephrosis. OTHER: The left kidney is atrophic and echogenic measuring 9.7 cm in length without hydronephrosis. There is a superior pole 1.4 cm simple cyst.Moderate volume ascites.
1. Cirrhosis without focal liver lesion or biliary ductal dilatation. Moderate volume ascites.2. Cholelithiasis without cholecystitis.