Male 57 years old; Reason: Patient w/ history of NASH cirrhosis w/fever, RUQ ultrasound to eval for biliary tract pathology History: Patient with NASH cirrhosis, fever LIVER: The liver measures 16.4 cm in length. There is coarse increased echogenicity of the liver parenchyma with a nodular appearance, unchanged from prior CT. No focal hepatic lesions. The main portal vein is patent with normal hepatopetal flow measured at 53.8 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is surgically absent. The common hepatic duct measures 5.3 mm. The common bile duct was not well visualized and difficult to measure. No intrahepatic ductal dilation is seen.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 14.9 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 8.3 cm in length and appears atrophic. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 8.3 cm in length and appears atrophic. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No ascites is visualized.
1. The liver has coarse increased echogenicity and nodular appearance compatible with chronic liver disease. This appears stable from prior CT. No worrisome masses or ascites are seen.2. The gallbladder is surgically absent. There is no intra or extrahepatic ductal dilation seen.3. Splenomegaly.4. Bilaterally the kidneys appear echogenic and atrophic compatible with medical renal disease, as seen on prior CT.