61-year-old female patient with liver disease. Recent retroperitoneal bleed and cholelithiasis on CT abdomen without cholecystitis. Now with right upper quadrant pain. Evaluate for cholecystitis. LIVER: The liver measures 22.6 cm in length. Hepatic parenchymal echogenicity is coarsened. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.1 m/sec.GALLBLADDER, BILIARY TRACT: There are multiple gallstones. No gallbladder wall thickening or significant pericholecystic fluid is identified. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head of the pancreas demonstrates normal echogenicity. The body and tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 12 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 12.8 cm in length. No evidence of hydronephrosis.The spleen measures 8.7 cm in length.There is mild ascites.
1. Cholelithiasis without sonographic evidence of acute cholecystitis.2. Hepatomegaly and coarsened hepatic echogenicity suggestive of chronic liver disease/hepatic parenchymal dysfunction.3. Mild ascites. 