Reason: 79 yo male with CHF and new hyperbilirubinemia Examination somewhat limited by postsurgical changes in anterior abdominal wall.LIVER: The liver measures 14.2 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating biphasic hepatopetal flow with a velocity of 0.21 m/s. The hepatic veins appear prominent.BILIARY TRACT: The gallbladder is not visualized, and surgical clips in the right upper quadrant on prior chest radiograph suggests that the gallbladder is surgically absent. No intrahepatic biliary ductal dilatation is present. The common bile duct is mildly prominent measuring 8.9 mm in diameter which would not be unexpected status post cholecystectomy.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.7 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Increased parenchymal echogenicity and cortical thinning. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.7 cm in length. Increased parenchymal echogenicity and cortical thinning. No hydronephrosis.OTHER: Large ascites.
1.Findings suggestive of elevated right heart pressures.2.Increased hepatic echogenicity suggestive of parenchymal dysfunction which may be due to congestive hepatopathy.3.Large ascites.4.Increased renal echogenicity compatible with medical renal disease.