Congestive heart failure. Elevated LFTs. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 19 cm in length. No focal hepatic lesions. Normal direction of portal venous blood flow, with pulsatility and distended hepatic veins compatible with right heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. No cholelithiasis. The gallbladder wall is thickened, which may be seen in the setting of ascites. PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 8.0 cm in length. The renal parenchyma is echogenic. No suspicious renal lesions are evident. No hydronephrosis is present.The left kidney is 8.8 cm in length. The renal parenchyma is echogenic. There is a 5.3 cm solid and cystic mass at the inferior pole. No hydronephrosis is present.SPLEEN: 14.9 cm in length, without focal lesions evident.OTHER: Mild ascites is noted. Right pleural effusion, partially imaged.
1. Hepatomegaly with increased hepatic echogenicity compatible with parenchymal dysfunction. Multiple additional findings compatible with of congestive heart failure.2. 5.3 cm solid and cystic mass at the inferior pole of the left kidney, suspicious for neoplasm. Dedicated renal protocol CT or MRI is recommended for further evaluation.3. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease.