54-year-old male with metastatic esophageal carcinoma with severe abdominal pain and abnormal liver function. LIVER: Liver is heterogeneous in echotexture and normal in size. Discrete mass is not seen with certainty. There is now thrombosis of the portal venous system, progressive from the prior CT.GALLBLADDER, BILIARY TRACT: There appears to represent gallbladder is filled with echogenic material. The wall is not easily separated from internal material but is likely mildly thickened which is not specific in the face of ascites. No shadowing gallstones. There is now significant and diffuse biliary tract dilatation with the common duct measuring 1.7 cm in greatest diameter extending to the patient's known mass which infiltrates the porta hepatis.PANCREAS: Not discretely visualized. Large midline mass.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Significant ascites. Pleural effusions.
Biliary tract dilatation likely due to obstruction in the porta by metastatic disease. Portal venous thrombosis.Gallbladder sludge without shadowing stones.Diffuse, moderate ascites. Pleural effusions.