History of elevated alkaline phosphatase. Exam limited by positioning and patient body habitus. LIVER: The liver measures 15.5 cm in length. Numerous isoechoic hepatic lesions with hypoechoic halos are noted throughout the liver suspicious for metastases. An example lesion in the left lobe measures 3.4 x 4.8 x 3.3 cm. BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening. The sonographic Murphy's sign is negative. The common bile duct measures 5 mm in diameter.PANCREAS: The pancreatic duct is mildly prominent measuring 4 mm in diameter. SPLEEN: No significant abnormalities noted. The spleen measures 9.3 cm in length. RIGHT KIDNEY: Kidney measures 10.9 cm in length. Multiple right calyceal calculi the largest of which measures 9mm. Resolved hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length. Mild hydronephrosis with stent.OTHER: Ascites.
1.Multiple bilobar hepatic lesions suspicious for metastases. Example lesion in left lobe measures 3.4 x 4.8 x 3.3 cm. 2.Cholelithiasis without evidence of cholecystitis.3.Multiple right calyceal calculi the largest of which measures 9mm. Resolved hydronephrosis on right. 4.Mild left hydronephrosis with stent.5.Ascites. Discussed findings with Dr. Akoegbe at 11:00 a.m. on 2/13/2015. 