73-year-old male patient with history of alcohol cirrhosis, stable IPMN. Assess for malignancy, worsening portal hypertension. LIVER: The liver measures 12.1 cm in length, demonstrates coarsened hepatic echotexture, and is mildly nodular in contour. There is a hyperechoic lesion within the left hepatic lobe measuring 0.8 x 0.5 x 0.6 cm, previously 0.7 x 0.5 x 0.6 cm. A 1 cm left hepatic lobe cyst is again noted. Main portal vein flow is hepatopetal and measures 0.16 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones though no gallbladder wall thickening or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The head of the pancreas demonstrates normal echogenicity. The remaining pancreas is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9 cm in length and demonstrate increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 10.4 cm in length and demonstrate increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 9.4 cm in length.
1. Cirrhotic morphology of the liver without new suspicious hepatic lesion.2. Cholelithiasis without sonographic evidence of acute cholecystitis. 3. Medical renal disease. 