Female 70 years old; Reason: new onset ascites, evaluate liver and its vasculature History: ascites LIVER: Liver is normal in echotexture and echogenicity. No focal hepatic lesions. Hepatic length measures 17 cm. The main portal vein is patent with normal hepatopedal flow and a peak velocity of 25 cm/s. Hepatic veins appear prominent.GALLBLADDER/BILIARY TRACT: The gallbladder is normal in echotexture with the wall measuring 3 mm. A small nonshadowing focus is noted in the gallbladder which is mobile, likely representing a stone. The common bile duct measures 1 mm in diameter. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.8 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. Thr right kidney measures 11.1 cm and has normal vascular flow. No hydronephrosis. The right kidney demonstrates slightly increased echogenicity.The left kidney is not wall visualized secondary to ascites. The left kidney measures 10.1 cm and has normal vascular flow. No hydronephrosis.OTHER: Moderate amount of ascites is noted in the upper quadrants. Enlarged heart is partially visualized.
1.Normal echotexture and echogenicity of the liver with moderate ascites in the upper quadrants.2.Partial visualization of the enlarged heart with enlarged hepatic veins, suggestive of right-sided heart failure.3.Cholelithiasis.4.Slight increased echogenicity of the right kidney, which is nonspecific and may be seen with medical renal disease.