Female 83 years old; Reason: r/o CBD obstruction History: jaundice LIVER: The liver measures 18.4 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. The main portal vein is patent with normal hepatopetal flow measured at 52.2 cm/s. GALLBLADDER/BILIARY TRACT: There is intrahepatic as well as extrahepatic ductal dilation. The gallbladder wall measures 2.1 mm and the gallbladder is distended. No stones or sludge are seen. No pericholecystic fluid. The common bile duct measures 14.6 mm in diameter. PANCREAS: The majority of the pancreas is obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 11.8 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 9.7 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 9.5 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.
1. Mild hepatomegaly with increased echogenicity of the liver parenchyma compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses seen.2. Intrahepatic as well as extrahepatic ductal dilation; the distal common bile duct is not visualized due to overlying gas and a distal obstructing lesion including mass cannot be excluded. The gallbladder is also distended. Recommend further cross-sectional imaging to evaluate a potential source of obstruction.3. Bilaterally the kidneys have increased echogenicity compatible with medical renal disease.