55-year-old male patient with systemic amyloid with cholestatic transaminitis. Assess for portal vein thrombosis. The patient has abdominal situs inversus.LIVER: The liver measures 21.7 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.1 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains sludge. The gallbladder wall measures 4 mm in thickness, which is borderline though nonspecific in the setting of ascites.. The common duct measures 12 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 11.2 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is increased.OTHER: The left kidney measures 11.2 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is increased.The spleen measures 14.1 cm in length. A cystic area in the spleen measures 7.7 x 6.0 x 3.5 cm, not significantly changed in size.There are bilateral pleural effusion and mild ascites.
1. Abdominal situs inversus.2. Hepatomegaly, mild ascites, and biliary sludge.3. Unchanged cystic area in the spleen.4. Medical renal disease. 5. Pleural effusions.