54-year-old female patient in ARDS with refractory shock. Evaluate for biliary/gallbladder pathology. LIVER: The liver measures 17.2 cm in length and demonstrates coarsened hepatic echotexture. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 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 measures 10.2 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 10.0 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 9.6 cm in length.
1. Coarsened hepatic echotexture which can be seen with hepatic parenchymal dysfunction.2. Medical renal disease. 