38-year-old male patient with heart failure. Evaluate possible liver pathology. LIVER: The liver is coarsened in echotexture. There is hepatopetal blood flow with peak velocity of 37 cm/s in the main portal vein.BILIARY TRACT: The gallbladder wall is thickened, which is not abnormal in the setting of intra-abdominal ascites. No cholelithiasis. There is no intra or extrahepatic biliary ductal dilatation.PANCREAS: The pancreas is largely obscured by overlying bowel gas.SPLEEN: Splenomegaly, measuring up to 12.9 cm in length.RIGHT KIDNEY: The right kidney measures 10.7 cm in length. There is no hydronephrosis or shadowing renal calculi.OTHER: There is a moderately large amount of mildly complex ascites.The left kidney measures 10.4 cm in length. No hydronephrosis or shadowing renal calculi.
1.Coarsened liver echotexture is compatible with nonspecific parenchymal dysfunction/fatty infiltration.2.Splenomegaly.3.Moderately large intra-abdominal ascites, which is minimally complex.