Cryptogenic cirrhosis. Evaluate for hepatocellular carcinoma. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. Loss of signal intensity on in phase imaging, compatible with iron deposition. The portal vein is patent at the splenic/SMV confluence. There is occlusive thrombus within the extrahepatic portal vein just distal to the confluence and within the intrahepatic portal vein. No enhancing lesions are identified. Numerous portal systemic varices.SPLEEN: Splenomegaly, measuring 13.0 cm in the coronal plane.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst. The left kidney is unremarkable. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction or ileus. Moderate to large volume of abdominal pelvic ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: New small bilateral pleural effusions, left greater than right.
1.Cirrhotic morphology of the liver, with no evidence of hepatocellular carcinoma.2.Occlusive thrombus of the extra hepatic and intrahepatic portal vein, just distal to the splenic/SMV confluence.3.Moderate to large volume of abdominal pelvic ascites, unchanged.4.New small bilateral pleural effusions, left greater than right.