Male 33 years old Reason: eval for liver masses, bile duct stones, portal blood flow History: acute liver failure w/ ascites, significant alcohol abuse LIVER: There demonstrates significantly increased echogenicity consistent with fatty infiltration. Liver measures 20.5 cm. Main portal vein and left portal vein demonstrate hepatofugal flow. Flow in the right portal vein is hepatopedal.BILIARY TRACT: Gallbladder is distended with sludge and possible stones. Mild gallbladder wall thickening. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen measures 8.1 cm.RIGHT KIDNEY: Right kidney measures 10.5 cm. No evidence of hydronephrosis. OTHER: Small amount of ascites.Doppler findings:Hepatic artery is patent. Flow in the main portal vein and left portal vein is reversed. Flow in the right portal vein is hepatopedal. Splenic vein is patent.
Hepatomegaly with severely echogenic liver. Reversed flow direction the main portal vein and left portal vein consistent with portal hypertension. Small amount of ascites.