62-year-old male with fever, abdominal pain. Evaluate for up quadrant from gallbladder pathology. Limited exam as patient unable to lie in the decubitus position or check for Murphy's sign. Midline bandage partially obscures the left liver and pancreas.LIVER: Increased echogenicity of the liver measuring 21.4 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Multiple shadowing stones within the gallbladder. Trace pericholecystic fluid. Gallbladder wall measures up to 3 mm in thickness. Unable to check for sonographic Murphy sign. Common bile duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Normal echogenicity of the visualized pancreas.RIGHT KIDNEY: Increased echogenicity of the right kidney measuring 11.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 14.4 cm in length.Left kidney measures 12.0 cm in length and is increased in echogenicity. No hydronephrosis or shadowing calculi are noted.
1. Cholelithiasis with trace pericholecystic fluid. Findings may represent early cholecystitis.2. Hepatomegaly with increased echogenicity of the liver compatible with fatty infiltration.3. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No hydronephrosis.