72-year-old female patient with GIB, concern for cirrhosis. Evaluate morphology of the liver. LIVER: The liver measures 13.1 cm in length. Hepatic parenchymal echogenicity is increased and coarsened, which limits sensitivity for detection of subtle lesions. Possible micronodular liver contour. Main portal vein flow is slow but patent and hepatopetal measuring 0.16 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains sludge. The gallbladder wall is mildly thickened measuring 5 mm, which is nonspecific in the setting of ascites. No pericholecystic fluid is identified. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.6 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.9 cm in length. No evidence of hydronephrosis.The spleen measures 10.2 cm in length.There is mild ascites and a left pleural effusion.
1. Increased hepatic echogenicity which may be seen with hepatic steatosis/hepatic parenchymal dysfunction. Possible micronodular liver contour which may be seen in setting of cirrhosis; if there is continued clinical concern, further evaluation with dedicated CT imaging suggested.2. Biliary sludge with mild gallbladder wall thickening which is non-specific in the setting of ascites and liver disease.3. Mild ascites and left pleural effusion.