59-year-old female patient with shortness of breath, abnormal LFTs. Evaluate liver and for portal vein thrombosis. LIVER: The liver measures 11.4 in length and is nodular in contour. A subcentimeter hypoechoic nodule is again noted in the right hepatic lobe. Main portal vein flow is poorly visualized on color Doppler imaging but appears hepatopetal measuring 0.1 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. The common bile duct is dilated measuring up to 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 13.7 cm in length and contains two cysts with the largest measuring up to 7.6 cm. No evidence of hydronephrosis. Renal cortical echogenicity is increased. OTHER: The left kidney measures 14 cm in length. No evidence of hydronephrosis. Multiple cysts are again noted, the largest measuring 5.2 x 4.2 cm. Renal cortical echogenicity is increased.The spleen measures 15.6 cm in length. There are splenic varices. A pleural effusion is present.
1. Cirrhotic liver with limited evaluation of the portal vein which appears patent, but with sluggish flow. 2. Medical renal disease.3. Splenic varices. 