<p>&nbsp;</p><p><strong>&nbsp;</strong></p><p>The liver is normal in size with a span of 13.5cm and shows uniform parenchymal echo pattern with intact regular capsule. No focal hepatic mass lesion is seen. The gall bladder is demonstrated with good mucosal wall coating, no stone or sludge seen within it. The intra-hepatic biliary system and the common bile duct are within normal limits. However, there is marked dilatation and tortuosity of the main portal vein (measuring 22 mm in diameter) and its branches. Spectral Doppler interrogation revealed flow reversal at porta hepatis.</p><p>The pancreas and the para aortic regions are within normal limits.&nbsp;</p><p>The spleen is grossly enlarged extending up to the left iliac fossa but shows normal parenchyma echo pattern. In addition, the splenic veins is also dilated, measuring up to 10 mm at the hilum. It also showed flow reversal, suggesting high portal venous pressure. Nevertheless, no evidence of thrombus is seen within it.</p><p>The kidneys are normal in size, shape, and outline. They have good cortico-medullary differentiation and normal central sinus echoes. No pelvicalyceal system dilatation or calculus is seen. The urinary bladder is well distended with urine with good mucosal wall coating, no sludge or calculus seen.</p><p>The prostate gland and the visualized bowel loops are within normal limits.&nbsp;</p><p>There is no ascies.</p><p>&nbsp;</p><p><strong>Conclusion</strong>: Massive splenomegaly with portal hypertension.</p><p>Abdominal CT scan with hepatic protocol is recommended</p>