74-year-old male with alcoholic cirrhosis, ascites, and acute kidney failure. LIVER: Cirrhotic liver contour with significant perihepatic ascites. The liver measures up to 14 cm in length. The main portal vein demonstrates normal hepatopedal flow and measures 15 cm/s.GALLBLADDER, BILIARY TRACT: The gallbladder is partially collapsed, which limits evaluation for wall thickening. Shadowing gallstones are suspected. Normal common bile duct measuring 2 mm in diameter.PANCREAS: Pancreas is obscured due to overlying bowel gas.SPLEEN: The spleen measures 12.4 cm in length, and a 1.8 x 1.7 cm splenule is noted.KIDNEYS: The right kidney measures 10.7 cm in length, and there is no hydronephrosis. The left kidney measures approximately 10 cm in length, and no hydronephrosis is identified. Nonspecific mild increased echogenicity of the bilateral renal parenchyma. ABDOMINAL AORTA: Proximal abdominal aorta measures 2.3 cm in AP diameter.INFERIOR VENA CAVA: Poor evaluation with color Doppler.OTHER: Prominent ascites, which is more evident of the upper abdomen.
1. Cirrhotic contour of the liver with prominent upper abdominal ascites.2. Cholelithiasis without sonographic evidence for acute cholecystitis.3. No hydronephrosis. Mildly increased echogenicity of the renal parenchyma could represent chronic renal disease.