Evaluate for right upper quadrant obstructive liver disease, new hyperbilirubinemia with coagulopathy LIVER: Diffuse coarse echotexture of the liver remains unchanged, mildly enlarged measuring 20 cm. Perihepatic fluid noted. No intrahepatic biliary ductal dilatation. No focal lesion.Main portal vein is patent with normal flow directionality.BILIARY TRACT: Gallbladder wall appears mildly thickened probably related to adjacent ascites. Sonographic Murphy sign cannot be assessed. No evidence of gallstones.Common bile duct measures up to 4 mm without any stones within it.PANCREAS: Not well visualized due to overlying bowel gas.OTHER: Mild ascites, minimally increased from prior examination and mild right pleural effusion.
Coarse echotexture of the liver, enlarged liver, suspicious for parenchymal dysfunction.Thickened wall of the gallbladder secondary to adjacent ascites which appears minimally increased.Mild right pleural effusion.CBD measurement within normal limits without evidence of any stones.