Reason: Rising bilirubin and jaundice 8 months status post stem cell transplant with Busulfan conditioning. Concern for cholecystitis, cholelithiasis, GVHD, or VOD LIVER: The liver measures 18.0 cm in length. Normal hepatic echogenicity and echotexture. The portal vein is patent with normal directional hepatopedal portal venous blood flow, peak velocity 23.3 cm/s. Peak velocity of the right portal vein is -16.1 cm/s and left portal vein is 10.4 cm/s. Normal hepatic arterial directional blood flow. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The gallbladder wall measures 0.1 cm. The common hepatic duct measures 0.3 cm. No biliary ductal dilatation.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 12.8 cm. Small subcentimeter nonobstructing renal stone in the mid portion of the right kidney. No hydronephrosis or masses.LEFT KIDNEY: The left kidney measures 13.3 cm. No hydronephrosis, masses, or stones.SPLEEN: The spleen measures 12.1 cm. Peak splenic vein velocity is 18.4 cm/s. Peak splenic artery velocity is 48.7 cm/s. Abnormal directional venous and arterial flow.OTHER: No ascites.
1. Subcentimeter nonobstructing right renal stone.2. Unremarkable hepatobiliary system with normal hepatopedal directional portal venous and arterial flow.