Male 63 years old; Reason: eval for cause of hyperbilirubinemia, r/o clot with dopplers History: hyperbilirubinemia LIVER: The liver measures 16.6 cm in length. There is coarse increased echogenicity of the liver parenchyma. A vague a hyperechoic lesion is seen in the right lobe of the liver measuring 3.3 cm x 3.0 cm x 2.8 cm. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 26.1 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is contracted and the wall measures 3.9 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 4.2 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 16.1 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 15.4 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 14.7 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: Trace ascites is seen.
1. There is increased coarse echogenicity of the liver parenchyma compatible with fatty infiltration/hepatocellular dysfunction.2. A vague hyperechoic lesion is seen in the right lobe of the liver. A discrete mass cannot be excluded and recommend contrast enhanced cross-sectional imaging for further characterization of this lesion.3. Splenomegaly and trace ascites are present.