Cirrhosis – On Ultrasound

History: 50 year old male with abdominal pain and swelling. 

Cirrhosis with ascites: Ultrasound image of the right upper quadrant of the abdomen reveals free fluid surrounding the liver, as well as a nodular contour to the liver surface.

This is the typical appearance of cirrhosis on ultrasound. The best indicator of cirrhosis on ultrasound is a nodular contour to the liver surface, as seen above. Cirrhosis typically occurs in stages. Early on, the liver size may be enlarged. As cirrhosis progresses, the liver becomes increasingly nodular and shrunken. Additionally, the cirrhotic liver will have a coarse echotexture.

Alcohol causes 60-70% of the cases of cirrhosis and is the third leading cause of death in middle aged men. The 5 year survival rate for patients with alcoholic cirrhosis is 50%.