Male 52 years old Reason: decompensated cirrhosis, eval hepatic artery \T\ portosystemic shunts History: check liver doppler ABDOMENLIVER: Diffusely coarse and echogenic nodular appearance of the liver compatible with cirrhosis. No focal hepatic mass.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Gallbladder is distended with mild gallbladder wall thickening measuring up to 4.6 mm, which may be seen in the setting of cirrhosis. Layering sludge is present within the gallbladder. No shadowing gallstones.PANCREAS: Pancreas is obscured by overlying bowel gas.SPLEEN: Spleen is enlarged measuring 19.1 cm. Normal background echogenicity. KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Left kidney measures 11.5 cm. Right kidney measures 10.9 cm.OTHER: Right pleural effusion and mild to moderate ascites are present.
1.Cirrhotic liver morphology, consistent with given history. Reversed flow (hepatofugal) in the main, left, and right portal veins.2.Splenomegaly.3.Right pleural effusion and mild to moderate ascites.