70 year old male patient with epigastric stomach pain reminiscent of past gallstone attack. Question of gallstones. LIVER: The liver measures 19.9 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains non-dependent shadowing echogenic foci and dependent non-shadowing material. There is no significant gallbladder wall thickening or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas. The visualized pancreatic duct is non-dilated.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.2 cm in length. No evidence of hydronephrosis.The spleen measures 13 cm in length. Multiple subcentimeter echogenic foci are noted within the spleen.
1. Air and biliary sludge within the gallbladder are likely related to the patient's history of gallstone ileus, as seen on prior CTs. No sonographic evidence of acute cholecystitis. 2. Subcentimeter echogenic foci within the spleen are non-specific but likely benign in etiology, possibly representing hemangiomas. 