50-year-old female has SIRS and positive Murphy sign. Evaluate for hepatobiliary pathology. LIVER:The liver measures 26 cm in length. There is coarse, increased, and heterogeneous echotexture of the parenchyma. There is a 1.5 x 1.1 x 1.2 cm round anechoic lesion in segment 3 of the liver that is consistent with a simple cyst. No masses or ascites. No intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended without evidence of sludge or stones. The gallbladder wall measures 0.2 cm. No pericholecystic fluid. The common bile duct measures 0.7 cm. Negative sonographic Murphy's sign.PANCREAS: Evaluation is limited due to overlying bowel gas, however the visualized portions appear normal.SPLEEN: The spleen measures 18.0 cm. Otherwise, no abnormalities noted.KIDNEYS: Left kidney measures 12.9 cm. The cortex has normal echogenicity. No shadowing calculi are seen. No hydronephrosis noted. Right kidney measures 13.0 cm. The cortex has normal echogenicity. No shadowing calculi are seen. No hydronephrosis noted. ABDOMINAL AORTA: Patent without aneurysm.INFERIOR VENA CAVA: Patent without thrombus.OTHER: No significant abnormality noted.
1. Coarse, increased, and heterogeneous echotexture of the liver consistent with chronic liver disease/parenchymal dysfunction.2. Hepatosplenomegaly.3. No sonographic evidence of gallbladder pathology.