Clinical concern for primary sclerosing cholangitis. LIMITED ABDOMENLIVER: The liver measures 15.4 cm in length. There is course, increased, and heterogeneous echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation or ascites.BILIARY TRACT: The gallbladder wall measures 3.0 mm. No stones are seen. No pericholecystic fluidPANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearanceSPLEEN: The spleen measures 15.2 cm and no significant abnormalities are noted RIGHT KIDNEY: The right kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. There is a round 1.5 x 1.0 cm well-defined, hypoechoic lesion in the right kidney consistent with simple renal cyst.LEFT KIDNEY: The left kidney measures 10.9 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.
1. Increased, course, and heterogenous echotexture of liver consistent with chronic liver disease / parenchymal dysfunction with probable early cirrhotic morphology. No mass.2. There is a previously noted portal vein thrombosis involving the entire portal venous system with cavernous transformation and collateral formation.3. Interval resolution of ascites when compared to the prior study.4. Splenomegaly.