78-year-old male presents with abdominal pain. There is clinical concern for mesenteric ischemia. LIVER:Measures 15.0 cm. Coarse echotexture of liver. No mass, ascites, or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: Gallbladder is nondistended with an anechoic lumen. The wall measures 2.0 mm. No pericholecystic fluid, stones, or sludge. Common bile duct measures 2.9 mm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 9.6 cm without sonographic abnormalities.KIDNEYS: Right kidney is 11.7 cm. Left kidney is 12.1 cm. Kidneys are mildly echogenic bilaterally. No hydronephrosis, shadowing calculi, or focal mass. TECHNIQUE: Doppler flow images were obtained on abdominal vasculature.ABDOMINAL AORTA: Patent without aneurysm.OTHER: The celiac artery is patent with peak systolic velocity at 223.1 cm/s. The resistive index is 0.71.The superior mesenteric artery is patent with peak systolic value 172.0 cm/s. The resistive index is 0.83.The inferior mesenteric artery is shadowed out by bowel gas and not evaluated on this study.
1. Coarse echotexture of liver consistent with chronic liver disease/parenchyma dysfunction. No mass or ascites.2. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction. No hydronephrosis.3. Aorta without evidence of aneurysm. Celiac artery and SMA are patent as above. IMA inadequately evaluated on this study.