History of diabetic ketoacidosis and choledocholithiasis on CT. The study was severely limited due to poor ultrasound penetration and patient confusion.LIVER: The liver measures 17.3 cm in craniocaudal dimension. Normal hepatopedal portal venous blood flow at 0.3 cm/s.Partially distended gallbladder with sludge and small layering gallstones. Minimal nonspecific wall thickening. No pericholecystic fluid.BILIARY TRACT: The common bile duct measures 5 mm. No choledocholithiasis is identified, but the study is limited as described above.PANCREAS: The pancreas was not visualized due to overlying bowel gas shadowing.SPLEEN: The spleen is not visualized.RIGHT KIDNEY: The right kidney is atrophic measuring 6.6 cm without hydronephrosis. OTHER: The left kidney is atrophic measuring 6.4 cm without hydronephrosis.
Very limited study as described above. The choledocholithiasis identified on the recent CT is not visualized. Cholelithiasis without specific evidence of acute cholecystitis. If cholecystitis is of clinical concern a HIDA scan may be considered as clinically warranted.