54-year-old man with history of NASH cirrhosis, preliver transplant evaluation. ABDOMEN:LIVER, BILIARY TRACT: The liver is cirrhotic in morphology. The splenic vein and SMV are patent. The extrahepatic portal vein is markedly narrowed (series 14, image 41) measuring less than 3 mm. The intrahepatic right and left portal veins are patent, however they are also attenuated in caliber.No focal hepatic lesion is identified. Specifically, the previously seen segment 7 lesion is not identified on today's study, possibly a perfusional abnormality. Trace perihepatic ascites is noted.SPLEEN: Spleen is mildly enlarged, but otherwise unremarkable.PANCREAS: The pancreas appears normal.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcapsular left midpole cystic lesion unchanged. The kidneys are otherwise normal and enhance symmetrically.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy noted.BOWEL, MESENTERY: There are loops of bowel within a right lower quadrant ventral hernia, but no evidence of incarceration or obstruction. The remaining small bowel and colon appear normal.BONES, SOFT TISSUES: Scoliosis with thoracic compression fractures unchanged.OTHER: No significant abnormality noted.
1.Cirrhotic liver. Previously seen hepatic lesion not identified on today's study, probably perfusional.2.Portal vein is markedly attenuated from the level of the confluence and appears narrower than the prior study. Finding discussed with Dr. Te by phone at 11:20 on 11/12/2015.3.Growing right lower quadrant ventral hernia, now containing loops of bowel without evidence of incarceration.