<p>There is Hepatomegaly with AP diameter of 155mm and shows uniform parenchymal echopattern. No focal hepatic mass lesion is seen. The intrahepatic vascular channels and IVC are dilated with IVC measuring 21mm in diameter. The intrahepatic biliary channels and CBD are not dilated.&nbsp;</p><p>The gallbladder is moderately distended with bile and clear contents and mucosal wall thickness. No calculus is seen within it.&nbsp;</p><p>The kidneys are normal in positions, shapes, sizes and outlines. They measure 104 and 89mm in their respective bipolar length on the right and left sides. They show increased in their parenchymal echogenicity greater than that of the Liver and spleen on the right and left sides with loss of corticomedullary differentiation. No definite focal renal mass lesion or hydronephrosis is seen.</p><p>The spleen is normal in size and shows uniform parenchymal echopattern. No focal intrasplenic mass or collection is seen.&nbsp;</p><p>The pancreatic bed, paraaortic area and the urinary bladder are within normal limits.</p><p>The visualized bowel loops shows normal caliber, outline and peristaltic activity. No bowel mass lesion is seen. There is moderate ascites demonstrated with bilateral pleural effusion.</p><p>The uterus is normal in size and empty. It measures 28mm in it is widest AP diameter. It shows uniform myometrial and endometrial echos. It shows no definite focal myometrial or endometrial mass lesion seen. Both adnexae are free.&nbsp;</p><p><strong>Conclusion – Bilateral grade III renal parenchymal disease with cardiac decompensation</strong></p>