Male 60 years old; Reason: assess for liver abnormalities, hepatic congestion. History: increasing liver enzymes LIVER: The liver measures 16.6 cm in length. There is coarse increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 28.9 cm/s. There is a small amount of ascites and right pleural effusion.GALLBLADDER/BILIARY TRACT: No stones are seen in the gallbladder, only minimal sludge. The gallbladder is incompletely visualized due to LVAD. No pericholecystic fluid. The common bile duct measures 3.6 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.4 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.5 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.2 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.
1. The liver has coarse increased echogenicity which is compatible with fatty infiltration/hepatocellular dysfunction. A small amount of ascites is present as is a right pleural effusion.2. Bilaterally the kidneys have increased echogenicity which is compatible with medical renal disease.