Male 65 years old; Reason: eval for liver disease, obstruction History: new uptrending LFTs, cholestatic pattern LIVER: The liver measures 16.8 cm in length. There is coarse increased echogenicity of the liver parenchyma. There is a anechoic cyst at the superior left portion of the liver measuring 1.9 cm x 2 cm x 2.4 cm. This corresponds to prior CT. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 27.4 cm/s. There is a small volume of ascites.GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 9.2 mm and appears contracted with sludge. No stones are seen. No pericholecystic fluid. The common bile duct measures 6.3 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 12.4 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.2 cm in length. The cortex has increased echogenicity. Renal stent is visualized, no hydronephrosis. There is a round isoechoic lesion seen along the midportion of the right kidney measuring 3.3 cm x 2.9 cm x 3.9 cm. This was visualized on prior CT. No stones or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 11.6 cm in length. The cortex has increased echogenicity. Renal stent is visualized with mild hydronephrosis. No stones or worrisome masses are seen.OTHER: No significant abnormality noted.
1. The liver appears coarsely echogenic which is compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses are seen. There is a small volume of ascites.2. Bilateral renal stents are visualized with mild hydronephrosis seen on the left. Both kidneys demonstrate increased echogenicity which is compatible with medical renal disease.