57-year-old male patient with right upper quadrant tenderness. Assess for hepatic etiology. LIVER: The liver measures 16.9 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and contains a large amount of layering echogenic material. There is no significant pericholecystic fluid or gallbladder wall thickening. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney is poorly visualized but echogenic and contains at least one cyst.OTHER: The left kidney measures 11.4 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is increased and heterogeneous, correlating to numerous small cysts on prior CT, which are poorly visualized on this exam.The spleen measures 10.9 cm in length.
1. Distended gallbladder filled with echogenic material though specific surrounding inflammatory changes; HIDA scan may be considered for further evaluation if clinically indicated. 2. Medical renal disease and numerous renal cysts, which are poorly evaluated on this study and seen better on prior CT.