28-year-old female presents after overdose of acetaminophen. LIVER: The liver measures 13.1 cm. There is increased, coarse, heterogeneous echotexture of the liver. No masses, ascites, or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: There is mild pericholecystic fluid and gallbladder wall is slightly thickened measuring approximately 5.5 mm. There is a negative sonographic Murphy's sign. No stones or sludge. PANCREAS: Evaluation the pancreas limited due to overlying bowel gas.SPLEEN: The spleen measures 11.7 cm. No sonographic abnormalities noted.KIDNEYS: The right kidney measures 11.8 cm. The cortex has normal echogenicity. No shadowing calculi, hydronephrosis, or worrisome masses. The left kidney measures approximately 12.4 cm. The cortex has normal echogenicity. No shadowing calculi, mass, or hydronephrosis. OTHER: No significant abnormality noted.
1. Increased, coarse, heterogeneous echotexture of liver consistent with hepatic parenchymal dysfunction. No mass or ascites.2. Mild pericholecystic fluid and gallbladder wall thickening with a negative sonographic Murphy's sign and without biliary dilation. Some element of acute inflammation cannot be excluded.