Male 59 years old Reason: Patient w/ recent PD cath removal, notes abd distension, fluid, concern for passive hepatic congestion vs dwelling dialysate History: abd distension LIVER: Increased liver echogenicity with a mildly coarse appearance which can be secondary to fatty infiltration or diffuse hepatic dysfunction. No focal mass. Liver measures 16.1 cm. Main portal vein is patent with normal directional flow and a normal waveform. Peak velocity at the portal vein is 35 cm/s. No specific evidence of cirrhosis.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. The gallbladder appears contracted with shadowing stones. The gallbladder wall is slightly thickened measuring 4 mm, however this is likely secondary to contraction. Common bile duct measures 5 mm. Negative Murphy's sign.PANCREAS: Visualized portions of the pancreas are normal in appearance.SPLEEN: Spleen is slightly enlarged measuring 14.9 cm. Small splenule is present.KIDNEYS: Kidneys are atrophic and echogenic. No hydronephrosis or mass is identified. OTHER: Large volume ascites with multiple septations, some of which may be loculated.
1.Large volume ascites with septations, suggesting it may be loculated.2.Nonspecific mildly increased echogenicity of the liver may be secondary to fatty infiltration or diffuse hepatic dysfunction. Portal vein is patent with normal directional flow.