Male 56 years old with persistently elevated bilirubin. Evaluate for gallbladder or liver pathology. Limited exam as the patient is intubated, the left side cannot be assessed. In addition, an open wound over the abdomen limits evaluation of the mid abdomen.LIVER: The liver measures 22 cm in length. The parenchyma is diffusely coarse and echogenic. There is a small amount of ascites, unchanged. The main portal vein is patent with a normal direction of flow and a velocity of 22 cm/s.BILIARY TRACT: No cholelithiasis. The gallbladder wall measures 2 mm in thickness. The common duct measures 5 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas could not be visualized due to the open abdominal wound and overlying bandages.SPLEEN: The spleen could not be visualized as the patient was intubated and could not be repositioned.RIGHT KIDNEY: The right kidney measures 13 cm in length. There is no hydronephrosis OTHER: The left kidney could not be visualized as the patient was intubated and could not be repositioned.
1.Hepatomegaly with coarse echotexture consistent with hepatic steatosis/parenchymal dysfunction.2.No cholelithiasis or biliary ductal dilatation.