History of hepatomegaly on CT in 2011 now with right lower quadrant and flank pain. LIVER: The liver measures 15.1 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating pulsatile hepatopetal flow with a velocity of 0.31 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: The spleen is not visualized likely related to close approximation to the diaphragm as seen on 2011 CT.RIGHT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted.
1.No evidence of acute cholecystitis, hydronephrosis, or other specific findings to account for patient's symptoms.2.Pulsatile blood flow in the portal vein raising the possibility of elevated right heart pressures.