65-year-old male patient with positive Murphy sign. Evaluate for cholecystitis. LIVER: The liver measures 13.2 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.27 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains stones and sludge. There is gallbladder wall thickening measuring up to 6 mm in certain areas. No significant pericholecystic fluid is identified. Sonographic Murphy's sign is negative, however, the patient is currently medicated. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney is atrophic and echogenic measuring 6 cm in length. No evidence of hydronephrosis. OTHER: The left kidney is not visualized on this examination.The spleen measures 13.1 cm in length.There is a right pleural effusion.
1. Cholelithiasis with mild gallbladder wall thickening; these findings could represent acute cholecystitis. A HIDA scan can be obtained for further evaluation if clinically warranted. 2. Right pleural effusion.3. Atrophic right kidney.