60 year-old male with cirrhosis status post TIPS. LIVER: Cirrhotic liver morphology without focal hepatic lesion. The liver measures 12.5 centimeters in length. The TIPS is patent, however the undivided left portal vein still demonstrates hepatopedal flow. GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance. There is no pericholecystic fluid, gallbladder wall thickening or cholelithiasis. PANCREAS: The head and proximal body of the pancreas are normal. The tail is obscured by bowel gas.SPLEEN: The spleen is normal in echogenicity and measures 16.3 cm in length. RIGHT KIDNEY: The right kidney measures 9.9 cm in length and shows diffusely increased echotexture. No stone or hydronephrosis. A 2.8 x 2.7 x 2.3 cm hypoechoic focus at the right upper pole may represent a discrete mass or may be due to artifact secondary to the echogenic cortex and irregular contour of the kidney.LEFT KIDNEY: The left kidney measures 12.8 cm in length and shows diffusely increased echotexture. No mass, stone or hydronephrosis.OTHER: No ascites.
1.The TIPS is patent, however the undivided left portal vein still demonstrates hepatopedal flow. No ascites.2.Diffusely increased echogenicity of both kidneys can be seen in the setting of medical renal disease/parenchymal dysfunction.3.A hypoechoic focus at the right upper pole may represent a discrete mass or may be due to artifact secondary to the echogenic cortex and irregular contour of the kidney. Would pay special attention to this lesion on future surveillance scans.