The liver was subnormal in size with increased portal markings and remodeling with an overwhelming gallbladder given the ratio between gallbladder and available hepatic parenchyma. A 2.1 cm hypoechoic nodule was noted in the mid liver. This is consistent with hyperplasia or potential carcinoma. Fine-needle aspirates would be warranted. A gastroazygos shunt was noted in this patient and was deriving from the portal vein in a ventral direction followed by dorsal direction and the loop entered into the esophageal inlet. This created a double aorta presentation in the caudal thoracic diaphragm. The portal vein at the hilus measured 0.29 cm, vena cava 0.4 cm, aorta 0.42 cm. The shunt at the esophageal inlet measured 0.51 cm. However, at its widest point it measured 0.95 cm. The kidneys presented polycystic renal changes in the cortices with disruption at the corticomedullary junction with generalized swelling and enlargement. Medullary calculi were also noted as well as corticomedullary calculi. These were only slightly obstructive at this time.