Elevated ammonia. LIVER: The liver is normal in morphology, size and contour. It is heterogeneous and mildly echogenic in echotexture. It measures 15.5 cm in craniocaudal dimension. No focal lesion. Normal hepatopedal portal venous blood flow at 22 cm/s.BILIARY TRACT: Normally distended gallbladder without wall thickening, pericholecystic fluid or focal tenderness. No gallstones. No biliary ductal dilatation. PANCREAS: The visualized portions of the pancreatic head and body are unremarkable.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Mild right-sided pelvocaliectasis. No shadowing nephrolithiasis or focal lesion. 11.4 cm in length.OTHER: The left kidney measures 10.3 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. The spleen is 9 cm in length.
Mildly coarse echogenic liver parenchyma may reflect parenchymal dysfunction and/or fatty infiltration.Mild right-sided pelvocaliectasis without shadowing nephrolithiasis.