75 year-old male with fever, abdominal pain, sepsis. Evaluate for cholecystitis. LIVER: Normal echogenicity of the liver measuring 18.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate direction of flow; the velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder unremarkable. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common hepatic duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas obscured by overlying bowel gas. The visualized portions are unremarkable.RIGHT KIDNEY: The right kidney measures 12.2 cm in length and is mildly increased in echogenicity. No hydronephrosis or shadowing calculi are noted. Cyst at the midpole measures 1.2 cm x 1.2 cm. OTHER: Left kidney measures 10.3 cm in length and is mildly increased in echogenicity. Hypoechoic focus not well assessed measuring approximately 2.3 cm x 1.9 cm x 1.5 cm.Spleen measures 12.7 cm in length.
1. Mildly increased echogenicity of the kidneys suggestive of medical renal disease.2. Bilateral cystic renal lesions as described above. 3. No sonographic evidence of acute cholecystitis.