Reason: please evaluate liver to assess for liver disease/cirrhosis History: elevated INR, low albumin LIVER: The liver measures 16.5 cm in length. Echogenic hepatic parenchyma with smooth peripheral contour. The portal vein is patent with normal directional hepatopedal flow, peak velocity 32.4 cm/s. The hepatic veins appear dilated. No focal mass.GALLBLADDER, BILIARY TRACT: Echogenic debris in the dependent aspect of the gallbladder may represent sludge. No shadowing stones. The gallbladder wall measures 0.2 cm. The common bile duct measures 0.2 cm. No biliary ductal dilatation.PANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney measures 12.7 cm in length. The left kidney measures 9.9 cm in length. Echogenic renal parenchyma. No shadowing stones or hydronephrosis.OTHER: The spleen measures 8.5 cm in length. Trace ascites. Bilateral pleural effusions.
1. Echogenic liver, consistent with parenchymal dysfunction or chronic liver disease.2. Bilateral pleural effusions and trace ascites.3. Dilated hepatic veins, suggestive of CHF.4. Echogenic debris in the dependent portion of the gallbladder may represent sludge.