Reason: Epigastric pain, exclude pancreaticobiliary abnormalities History: Epigastric pain, exclude pancreaticobiliary abnormalities LIVER: The liver measures 18.5 cm in length, enlarged. Heterogeneous, hyperechoic hepatic parenchyma. The portal vein is patent with normal directional hepatopedal flow, peak velocity 47.1 cm/s. The portal venous waveform is pulsatile and the hepatic veins appear dilated. No focal masses.GALLBLADDER, BILIARY TRACT: Small polyp on the nondependent aspect of the gallbladder body. No shadowing stones or sludge. No significant biliary ductal dilatation. The gallbladder wall measures 0.3 cm. The common bile duct measures 0.2 cm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 12.5 cm in length. The left kidney measures 12.6 cm in length. No hydronephrosis or shadowing stones.OTHER: No ascites. The spleen measures 14.2 cm.
1. Findings consistent with hepatic steatosis or parenchymal dysfunction. 2. Dilated hepatic veins and pulsatile portal venous waveform are suggestive of hepatic congestion or some degree of congestive heart failure.3. Gallbladder polyp should be followed up with repeat ultrasound in 3-6 months.