41-year-old female status post BMT, worsening bilirubin, jaundice. Evaluate for VOD versus obstruction. LIMITED ABDOMENLIVER: Enlarged measuring 21.0 cm in length and is heterogeneous in echotexture. No focal hepatic lesions. BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The visualized portions are unremarkable. SPLEEN: Spleen is enlarged measuring 16.2 cm in length.  RIGHT KIDNEY: Measures 12.1 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 12.6 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.Abdominal ascites.Incompletely visualized bilateral pleural effusions.
1. Hepatosplenomegaly with heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/infiltration. Patent inflow and outflow hepatic vasculature.2. Abdominal ascites and bilateral pleural effusions. 