59-year-old female with abnormal renal function, abnormal liver function and congestive heart failure. The exam is limited by patient's inability to cooperate and changed position.LIVER:Liver is moderately echogenic which is nonspecific but may be related to fatty infiltration. This has changed when compared to limited views from prior exam. Overall hepatic size is within normal limits. Main portal vein is patent with appropriate flow direction. Tracing is pulsatile which may be seen with congestive heart failure.GALLBLADDER, BILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. Visualized biliary tract is normal in caliber.PANCREAS: The body is normal. The head and tail are poorly visualized due to bowel gas.SPLEEN: Not visualized due to patient position.KIDNEYS: The right kidney measures approximately 10.7 cm in length. The left kidney is poorly visualized due to patient positioning, measuring approximately 11.3 cm in length. Mildly echogenic kidneys unchanged from prior exam. No hydronephrosis, shadowing calculus or mass. ABDOMINAL AORTA: Proximal and mid aorta normal in caliber. Distal aorta not demonstrated due to bowel gas.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Small amount of perihepatic fluid.
Echogenic liver possibly due to fatty infiltration.Normal gallbladder and biliary tract.Mildly echogenic kidneys without hydronephrosis.