70 year-old female. Her quadrant tenderness, liver distention, low platelets. Ultrasound for hepatomegaly, biliary disease, cirrhosis? LIVER: Normal echogenicity and echotexture of the liver. No focal hepatic mass. The liver is 15.9 cm in length. Hepatopetal portal venous flow with undulation of the waveform and dilated hepatic veins, likely related to congestion from right heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 4 mm in diameter, within normal limits. Cholelithiasis without evidence of acute cholecystitis.PANCREAS: Visualized pancreatic head is normal in echogenicity. The rest of the pancreas is obscured by bowel gas.OTHER: Small amount of right upper quadrant ascites.
1. Cholelithiasis without evidence of acute cholecystitis. No biliary ductal dilatation. Liver length is at the upper limits of normal. Small amount of perihepatic ascites.2. Findings consistent with right heart failure. 