The liver was subnormal in size with increased portal markings. Extrahepatic portosystemic shunt noted in this patient. It decourses dorsally into the region of an azygos entry. This is consistent with gastroazygos shunt and measured approximately 1.0 cm in width. The gallbladder presented excessive debris and sand/small calculus accumulation. Gallbladder congestion was noted. Gallbladder calculus measured approximately 0.8 cm. Echogenic debris or possible tissue proliferation was noted in the gallbladder in this patient. There is a minor potential for gallbladder neoplasia, yet this is most likely coalesced bile. The common bile duct in this patient presented a 0.71 cm calculus along with smaller calculi. The common bile duct measured 0.6 cm. Lobar biliary calculi were also present.

The kidneys revealed largely normal size and structure, corticomedullary definition and ratio (cortex 1/3 of medulla) were essentially maintained with some age related loss of curvilinear patterns. The cortices presented largely uniform texture with some age related echogenic changes that are not likely of clinical significance at this time unless inflammatory sediment or proteinuria is present. Medullary echogenicity differed distinctly from that of the cortex and no evidence or dilation could be seen. The capsules were acceptably uniform for this age patient without dramatic irregularities. Mineralization was noted in the kidneys. The right kidney measured 4.3 cm and the left kidney measured 4.16 cm.