Female 48 years old Reason: epigastric pain/ RUQ pain, loss of appetite History: as above LIVER: Echogenic liver parenchyma, which is nonspecific but may be seen in the setting of fatty infiltration or diffuse hepatic dysfunction. No focal hepatic mass. Main portal vein is patent with normal directional flow.BILIARY TRACT: Common bile duct is dilated measuring approximately 10 mm near the porta hepatis and distally tapering to 8 mm. No common bile duct stone is visualized. Gallbladder is normal in appearance. No gallstones. No intrahepatic biliary ductal dilatation.PANCREAS: Partially visualized portions of the pancreas are unremarkable.SPLEEN: Spleen is normal in appearance measuring 8.3 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass.. Right kidney measures 10.8 cm. Left kidney measures 10.9 cmOTHER: There is a multilobulated, predominantly anechoic collection, which appears peripherally calcified with septations. This does not definitely connect to the spleen or to the kidney.
1.Dilated common bile duct without ductal stone identified. Recommend MRCP for further evaluation of possible intraductal pathology and/or stone.2.Nonspecific multilobulated fluid collection in the left upper quadrant, which may originate from the adrenal gland or retroperitoneum. MRI of the abdomen will also help further evaluate this lesion.Discussed with ordering physician Dr. Veskovic. 