59-year-old male patient with abnormal LFTs, weight loss, scleral icterus. Evaluate for cholelithiasis, hepatomegaly, ascites. LIVER: The liver measures 13.9 cm in length. No focal hepatic lesion is identified. The liver is nodular in contour. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains biliary sludge and gallstones. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.3 cm in length. No evidence of hydronephrosis. There is a 1.9 x 2.2 cm simple cyst in the left lower pole.The spleen measures 8.5 cm in length.There is mild ascites.Bilateral pleural effusions are noted.The bladder is distended.
1. Nodular contour of the liver suggestive of cirrhosis2. Cholelithiasis without sonographic evidence of acute cholecystitis.3. Mild ascites and bilateral pleural effusions. 