67-year-old male with cirrhosis, PVT. Assess liver for HCC. Assess for portal vein thrombosis. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology with sequela of portal hypertension including splenomegaly, gastroesophageal varices, splenorenal shunt, and ascites. No suspicious arterially enhancing lesions or definite washout. Stable appearance of the previously described linear filling defect within the portal vein at the hepatic hilum branching into the right and left portal veins (series 10 image 263), favor to to represent a web. The intrahepatic main portal vein is diminutive but patent, however the extrahepatic main portal vein has an irregular appearance at the confluence and could arise from a collateral vessel. The SMV and splenic veins are also patent.SPLEEN: Splenomegaly measuring 15.7 cm in length.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No adrenal nodule is identified. There is a splenorenal shunt in close proximity to the normal left adrenal gland.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable small gastrohepatic and portacaval lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Right pleural effusion.
1.Hepatic cirrhosis and sequelae of portal hypertension. No suspicious hepatic lesion.2.Stable appearance of the previously described linear filling defect within the main portal vein at the hepatic hilum, likely representing a web. The portal vein is otherwise patent.3.Stable right pleural effusion and mild ascites.4.No evidence for an adrenal nodule. A splenorenal shunt is in close proximity to the normal left adrenal gland.