Reason: assess PVT History: PVT, cirrhosis ABDOMEN:LUNGS: A small right and trace left pleural effusion are new since the prior exam.LIVER, BILIARY TRACT: There is a cirrhotic liver morphology with perisplenic collaterals and perigastric and esophageal varices, similar to the prior exam. Right hepatic hypodensity without arterial enhancement appears similar to the prior exam (9/256). No suspicious hepatic lesions. There is linear hypodensity within the portal vein at the hepatic hilum branching into the right and left portal veins, likely represents a web, similar to the prior exam. The main portal vein is slightly diminutive but patent. The SMV and splenic veins are patent.SPLEEN: Splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly enlarged portacaval lymph node appears similar to the prior exam.BOWEL, MESENTERY: Colonic wall thickening likely represents hepatic colopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate abdominal ascites appears to the prior exam.
1.Hepatic cirrhosis and sequela of portal hypertension without suspicious hepatic lesions.2.Linear filling defect within the main portal vein at the hepatic hilum likely represents a web from recannulization of prior thrombus, appearing similar to the prior exam. The portal vein is otherwise patent.3.Ascites and right pleural effusion suggestive of hepatic hydrothorax.