70-year-old male requires evaluation prior to heart surgery. He has elevated bilirubin, bilateral lower extremity edema, dyspnea. LIVER: The liver measures 14.7 cm. The liver has coarse and increased echogenicity. No masses. No intrahepatic ductal dilatation. The portal vein is patent.BILIARY TRACT: The gallbladder is significantly dilated and is 7.2 cm at its maximum diameter. No stones. No pericholecystic fluid. Negative Murphy's. The gallbladder wall is measured at 1.9 m. The common bile duct is 6.22 mm, within normal limits for this patient's age.PANCREAS: Evaluation limited by overlying bowel gas.SPLEEN: The spleen measures 11.2 cm. No significant abnormalities noted.KIDNEYS: The right kidney measures 11.5 cm. The left kidney measures 12.1 cm. The cortex has normal echogenicity. No masses, stones, or hydronephrosis. OTHER: No significant abnormalities noted.
1. Distended gallbladder without acute inflammation at this time. No ductal dilatation.2. Increased and coarse echotexture of liver consistent with chronic liver disease/parenchymal dysfunction. No mass or ascites.