Reason: mixed cardiogenic/septic shock with rising LFTs and WBC, eval gall bladder for e/o cholecystitis, eval hepatic and portal vein for clot History: worsening shock Very limited examination due to patient positioning/body habitus.LIVER: The liver appears demonstrates increased echogenicity and coarse echotexture. No focal hepatic lesions. Hepatic length measures 14.5 cm. The main portal vein is patent with normal hepatopedal flow directed towards the liver with a velocity of 18.7 cm/s. GALLBLADDER/BILIARY TRACT: Gallbladder sludge noted, with the wall measuring 3 mm. No pericholecystic fluid collection. The common bile duct measures 2 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: Not visualized.KIDNEYS: The right kidney measures 13.7 cm and without evidence of hydronephrosis. The left kidney is not visualized.OTHER: Ascites is noted in the upper abdomen.
1.Very limited examination as above, with patient's left portal vein, hepatic arteries, right hepatic vein, splenic vein and artery, left kidney, and spleen not visualized.2.Increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction. No hepatic mass or ductal dilatation identified.3.Gallbladder sludge without evidence of cholecystitis or cholelithiasis.4.Patent main portal vein.