Reason: portal vein thromboses? History: rapidly accumulating abdominal ascites, presumably malignant. LIVER: The liver measures 11.2 cm in length. Focal solid hepatic lesion with hypoechoic rim within the right lobe measuring 6.1 x 3.7 x 2.8 cm compatible with metastatic lesion as seen on recent CT. The lesion appears slightly increased in size compared to the comparison CT. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.16 m/s.BILIARY TRACT: Cholelithiasis including stones within the gallbladder neck. Mild gallbladder wall thickening which is nonspecific but likely related to ascites. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2.6 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.3 cm in length. RIGHT KIDNEY: Kidney measures 8.6 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.0 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Large volume ascites, increased from comparison CT.
1.Large volume ascites, increased. Main portal vein grossly patent.2.Hepatic metastasis, increased in size.3.Cholelithiasis. Nonspecific gallbladder wall thickening which may related to ascites. If there is clinical concern for acute cholecystitis, nuclear medicine HIDA scan could be considered.