Elevated INR, evaluate for cirrhosis. LIVER: The liver is enlarged and measures 20.2 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameterPANCREAS: Poorly visualized due to overlying bowel gas.SPLEEN: The spleen measures 14.6 cm in length and is heterogeneous in echotexture. Peripheral areas of low attenuation on the 11/17/2015 CT are nonspecific but raise the possibility of splenic infarcts.RIGHT KIDNEY: Kidney measures 13.8 cm in length. Normal echotexture. No hydronephrosis or mass. Two simple cysts are present in the right kidney the largest of which measures up to 3.9 cm.LEFT KIDNEY: Kidney measures 14.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: Bilateral pleural effusions.
1.Hepatomegaly and coarsened hepatic echotexture suggesting liver disease without specific morphologic features of cirrhosis.2.Heterogeneous splenic echotexture nonspecific but raising possibility of splenic infarcts.3.Bilateral pleural effusions.