59-year-old male with hepatitis C and ascites. Evaluate for cirrhosis. LIVER: The liver parenchyma is mildly coarsened. The liver measures 18.3 cm in craniocaudal dimension. The liver capsule is nodular consistent with cirrhosis. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec. The common bile duct is 2 mm at the hepatic hilum, within normal limits.BILIARY TRACT: A partially distended gallbladder is present with diffuse wall thickening up to 7 mm which is nonspecific in the setting of hepatitis/cirrhosis. There are no gallstones, pericholecystic fluid, or focal tenderness.The common bile duct measures 4 mm at the pancreatic head, within normal limits.PANCREAS: Limited evaluation of the pancreatic body/head is unremarkable. SPLEEN: The spleen measures 11.8 cm in length, at the upper limits of normal.RIGHT KIDNEY: The right kidney measures 7.9 cm. It is atrophic with cortical thinning and hyperechogenicity compatible with chronic medical renal disease. No hydronephrosis or shadowing calculus is identified. Color Doppler demonstrates hilar blood flow.OTHER: There is a moderate amount of ascites.The left kidney measures 7.6 cm. It is atrophic with cortical thinning and hyperechogenicity compatible with medical renal disease. Note is made of a 9-mm simple-appearing cyst. No hydronephrosis or shadowing calculus is identified. Color Doppler demonstrates hilar blood flow.
1. Cirrhotic liver morphology without a discrete focal lesion.2. Diffuse gallbladder wall thickening is nonspecific in the setting of chronic liver disease and without associated specific findings of acute cholecystitis.3. Findings consistent with chronic medical renal disease.