The left kidney was mildly swollen and measured 7.87 cm with mildly increased cortical echogenicity. The liver itself was unremarkable with minor, coarse architecture with slightly increased portal markings. This appears to have adequate size in short axis measuring 7.0 cm. The portal vein revealed a large thrombus that measured 4.0 x1.3 cm. The thrombus appeared to occupy the portal vein completely causing prehepatic portal hypertension. Vascular intervention would be recommended to remove the clot. This appears to be significantly enlarged. Therefore, medical therapy will not likely allow for rapid dissolution. Secondary shunting was noted with irregular vessels likely derived from the region of the pancreaticoduodenal vein. This is consistent with secondary shunting. Areas of remodeling were noted in portions of the liver with expansive nodular changes.  A moderate amount of ascites was noted. Regional, echogenic fat was noted throughout the cranial abdomen owing to the ascites and echogenic artifact.