58 year old male with a history of ascites of unclear etiology. LIVER: The liver parenchyma is coarsened. It is normal in size, measuring 18.7 cm in craniocaudal dimension. The liver contour is smooth. There is no focal hepatic lesion or biliary ductal dilatation. Moderate volume perihepatic ascites. There is normal directional portal venous blood flow at 51 cm/sec.GALLBLADDER, BILIARY TRACT: Normally distended gallbladder with mild wall thickening, up to 4 mm, which is nonspecific in the setting of ascites. No cholelithiasis or focal tenderness. No extrahepatic biliary duct dilatation with common bile duct measuring 3 mm.PANCREAS: The visualized pancreatic body and head are normal.SPLEEN: The spleen is normal in size, measuring 11.5 cm.KIDNEYS: The right kidney measures 11.5 cm without hydronephrosis, shadowing nephrolithiasis, or discrete lesion evident. The left kidney measures 10.4 cm and is partially obscured, without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident. The renal cortices are echogenic. ABDOMINAL AORTA: The visualized proximal aorta is normal in caliber, measuring 1.9 cm.INFERIOR VENA CAVA: The visualized inferior vena cava is patent. OTHER: Bilateral pleural effusions and moderate volume ascites.
1. Bilateral pleural effusions and moderate volume ascites. 2. Coarse hepatic parenchyma, compatible with parenchymal dysfunction. 3. Medical renal disease.