57-year-old male patient with ascites in the setting of hepatitis C/cirrhosis. Evaluate common bile duct abnormality on abdominal ultrasound and for other abdominal etiology. ABDOMEN:LIVER, BILIARY TRACT: The common bile duct is mildly dilated measuring up to 10 mm in diameter but tapers distally without evidence of an obstructing mass/lesion. Mild central intrahepatic biliary ductal dilatation. Cholelithiasis without evidence of acute cholecystitis. Cirrhotic morphology of the liver. No focal hepatic lesion is identified. There is recannulization of the umbilical vein. SPLEEN: Mild splenomegaly measuring 15 cm in the craniocaudal dimension.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Gynecomastia.OTHER: There is a large right perihepatic multiseptated cystic mass occupying a majority of the right hemiabdomen; this causes mass effect on the adjacent liver and bowel. This lesion extends inferiorly outside of the field of view but measures at least 17 x 24 x 12 cm within the visualized portions. The infrahepatic IVC appears small in caliber. The azygous vein is prominent in size and there are multiple intraabdominal and body wall venous collateral vessels.
1.Large, multiseptated cystic perihepatic mass occupying the right hemiabdomen; this is favored to represent an evolving hematoma.2.Cholelithiasis without evidence of acute cholecystitis.3.Prominence of the common bile duct without evidence of an obstructing lesion. 4. Suggestion of central intrahepatic venous stenosis of the IVC with multiple intraabdominal and body wall venous collaterals. 