Right upper quadrant pain and fever. LIVER: The liver parenchyma is mildly heterogeneous and echogenic without a focal abnormality.BILIARY TRACT: The gallbladder is distended with wall thickening up to 3 mm and pericholecystic fluid, similar to prior study.No focal tenderness may be secondary to medication. Cholelithiasis is present.PANCREAS: Not evaluated.SPLEEN: Not evaluated.RIGHT KIDNEY: Not evaluated. OTHER: No significant abnormalities noted.
Dilated gallbladder with sludge and gallstones. Gallbladder wall thickening and pericholecystic fluid appearing similar to the prior study and again suspicious for acute cholecystitis in the correct clinical context. Fatty liver. 