45-year-old male patient with previous liver abscesses, as well as concern for cholangitis. Assess liver fluid collections. LIVER: The liver measures 20.4 cm in length and is diffusely heterogeneous in echogenicity with multiple more focal hypoechoic areas which likely correspond to multiple lesions seen on recent CT. No discrete drainable fluid collection is identified. No flow is detected within the main portal vein which appears occluded. A stent is noted in the liver. GALLBLADDER, BILIARY TRACT: The gallbladder is contracted and filled with echogenic material. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The pancreas is not visualized on this examination.RIGHT KIDNEY: The right kidney measures 13.4 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 13.2 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 10.3 cm in length.Bilateral pleural effusions are noted.
1. Diffusely heterogeneous hepatic parenchyma with focal areas of hypoechogenicity which appear to correlate with multiple lesions seen on recent CT. No discrete drainable collection is identified.2. Occluded main portal vein.3. Contracted, debris-filled gallbladder without definite sonographic evidence of acute cholecystitis.