Abnormal liver enzymes. History of renal cell carcinoma. Elevated creatinine. LIVER: Non-cirrhotic liver morphology. Coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. The gallbladder is distended with biliary sludge. There is mild gallbladder wall thickening and minimal pericholecystic fluid. No sonographic Murphy's sign is elicited.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.1 cm in length. The left kidney is 10.2 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 6.2 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent. 2.8 cm in maximal diameter, without aneurysm.INFERIOR VENA CAVA: Patent.OTHER: Prostatomegaly. Bilateral pleural effusions, partially imaged.
1. Increased hepatic echogenicity compatible with parenchymal dysfunction, without biliary ductal dilation.2. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease.3. Gallbladder distention, biliary sludge, and mild wall thickening suggestive of cholecystitis in the appropriate clinical setting.