History of alcoholic cirrhosis. Liver lesion follow-up. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Splenomegaly and ascites compatible with portal hypertension.The study is suboptimal to detect small hepatic lesions due to respiratory motion. The previously seen right hepatic dome lesion is not well seen on today's study. It may be seen on the delayed images (series 1504, image 78) and is not significantly changed in size and is too small to characterize. There appears to be complete thrombosis of the portal vein as well as thrombus extending into the SMV. Cavernous transformation of the portal vein is also suspected given the large number of collateral vessels in the porta hepatis.Suboptimal evaluation of the hepatic artery and hepatic veins.Normally distended gallbladder.SPLEEN: Mild splenomegaly measuring 13 cm in craniocaudal dimension. Perisplenic ascites.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is new left-sided hydroureteronephrosis with a very low-signal intensity suspected 8 mm calculus in the proximal ureter (series 2 image 25).Stable right renal superior pole simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: At least partial thrombosis of the SMV with mesenteric root collateral vessels. Large volume ascites, not significantly changed.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Suboptimal study as described with stable too small to characterize right hepatic dome subcentimeter lesion.2.Cirrhosis with portal hypertension and large volume ascites, unchanged. Portal vein thrombosis with cavernous transformation (also present on 6/24/15 outside hospital study).3.New left-sided hydroureteronephrosis with an 8 mm proximal ureteral obstructing stone.These findings were discussed with Dr. Te at 1420 on 7/27/2015.