Reason: Is there an aneurysm? History: Reported history of AAA LIVER: The liver measures 18.9 cm in length. The hepatic parenchymal echotexture and echogenicity is coarse. There is a mildly nodular hepatic contour, concerning for a cirrhotic liver morphology. There are no focal masses. The main portal vein is patent with normal directional hepatopedal flow, maximum systolic velocity 19.4 cm/s.GALLBLADDER, BILIARY TRACT: The common hepatic duct measures 2 mm in diameter. The gallbladder is moderately distended. There is a small echogenic focus in the dependent portion of the gallbladder with posterior acoustic shadowing, consistent with a small stone. There is no pericholecystic fluid. The gallbladder wall measures 2 mm. There is no biliary ductal dilatation. Murphy's sign was negative.PANCREAS: Obscured by bowel gas.SPLEEN: The spleen measures 16.9 cm in length.KIDNEYS: The left kidney measures 11.8 cm in length. The right kidney measures 11.9 cm in length. No hydronephrosis. ABDOMINAL AORTA: The abdominal aorta is obscured by bowel gas distally. The abdominal aorta measures 3.2 cm proximally and 2.9 cm more distally in the AP diameter. The distal abdominal aorta was nonvisualized. The arterial waveform is pulsatile, consistent with reported history of intra-aortic balloon pump.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Left pleural effusion. No free intraperitoneal fluid.
1. Echogenic coarse hepatic parenchyma with nodular contour, concerning for cirrhosis.2. Cholelithiasis without evidence of cholecystitis.3. Limited evaluation of the abdominal aorta without evidence of abdominal aortic aneurysm.