47-year-old male with cholecystitis, evaluate for choledocholithiasis, right upper quadrant pain, elevated liver function tests. Very limited examination secondary to patient body habitus.LIVER: Measures 22.1 in length. Markedly increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Redemonstration of cholelithiasis and gallbladder wall thickening with mild gallbladder distention. Very limited visualization of the common bile duct.PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted.
1.Cholelithiasis with persistent gallbladder wall thickening remains concerning for cholecystitis, either acute or chronic. Limited sensitivity for the detection of choledocholithiasis. If further imaging evaluation is warranted clinically, MRI/MRCP may be considered. 2.Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease.