Reason: assess for liver dysfunction. Examination somewhat limited by ventilator status and limitations positioning patient.LIVER: The liver measures 23.3 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. Blood flow within the main portal vein is apparently diminished measuring 15.6 cm/s and with possible intraluminal filling defects.BILIARY TRACT: Cholelithiasis as well as diffuse gallbladder wall thickening measuring up to 7 mm. The sonographic Murphy's sign was not elicited. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted.The spleen measures 8.8 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.8 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.OTHER: Moderate abdominal pelvic ascites.
1.Hepatomegaly and coarse hepatic echotexture suggestive of parenchymal dysfunction. 2.Moderate abdominopelvic ascites.3.Cholelithiasis. Gallbladder wall thickening which is nonspecific in the setting of liver disease and ascites, though cholecystitis not entirely excluded.4.Diminished flow and possible filling defects within the main portal vein which could be artifactual or due to thrombus. Correlation with cross-sectional imaging may be considered as clinically warranted.5.Echogenic kidneys suggestive of parenchymal dysfunction.Discussed with LIGTENBERG, KATHERINE 