Provided history of cirrhosis. Patient with sickle cell disease and schizophrenia. LIVER: The liver contour is lobular. The parenchyma is heterogeneously coarse compatible with stated history of chronic liver disease. No suspicious lesion is identified.Normal hepatopedal portal venous blood flow at 14 cm/s.BILIARY TRACT: The gallbladder is partially collapsed. The gallbladder wall measures 2 mm, within normal limits. No pericholecystic fluid or focal tenderness. Note is made of small gallstones. Adjacent to the gallbladder fundus is a 2.6 x 2.1 x 2.2 cm fluid collection which appears separate from the bowel and is of uncertain etiology. It may communicate with the gallbladder fundus.No intra or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreatic head and proximal body are unremarkable. Adjacent to the proximal body is a 2.5 x 1.4 x 2.5 cm hypoechoic lesion, previously measuring 1.8 x 1.7 cm.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. A small cyst is noted. OTHER: The left kidney measures 10.6 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. The spleen measures 6.5 cm in length.
1. Findings compatible with stated history of chronic liver disease without a focal lesion evident.2. Cholelithiasis without evidence of acute cholecystitis. Nonspecific 2.6 cm fluid collection adjacent to the gallbladder fundus is of uncertain etiology. 3. Enlarging 2.5 cm peripancreatic lesion may represent a large lymph node. A MR or CT is recommended for further characterization of this lesion and the fluid collection described above.