56-year-old male with high bilirubin, concern for cholangitis or a biliary source. Evaluate. LIVER: The hepatic parenchyma is normal in echotexture with the liver measuring approximately 20 cm. Portal venous flow is hepatopetal with the velocities measuring 15.8 cm/s in the main portal vein.BILIARY TRACT: Cholelithiasis, mildly distended gallbladder, gallbladder wall thickening and evidence of submucosal edema. Findings would be consistent with cholecystitis in appropriate clinical setting.No intra or extra hepatic biliary ductal dilatation. The common bile duct measures approximately 3 mm in diameter. No evidence of choledocholithiasis.PANCREAS: Mildly dilated pancreatic duct. SPLEEN: No significant abnormalities noted.KIDNEYS: The kidneys are mildly echogenic in echotexture. Right kidney measures 9.9 cm in length and the left kidney measures 9.7 cm in length. No evidence of hydronephrosis.OTHER: Small right pleural effusion. Moderate volume ascites.
1.Cholelithiasis, mildly distended gallbladder, gallbladder wall thickening and evidence of submucosal edema. Findings would be consistent with cholecystitis in appropriate clinical setting. Please note that gallbladder wall thickening is nonspecific in setting of ascites. 2.No intra or extrahepatic biliary ductal dilatation. No evidence of choledocholithiasis.3.Mildly distended pancreatic duct. A discrete stone is not definitely delineated, may be further evaluated with ERCP or MRCP. 4.Moderate volume ascites and small right pleural effusion.5.Hepatomegaly.