77-year-old male with shortness of breath. Evaluate for ascites, liver congestion. LIVER: Normal echogenicity of the liver measuring 16.4 cm in length. There is a subcentimeter calcified granuloma. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.BILIARY TRACT: Thickened gallbladder wall measuring 6 mm in thickness. There is a shadowing stone measuring up to 1.4 cm. No pericholecystic fluid. Sonographic Murphy sign is negative. Mild intrahepatic biliary ductal dilatation is noted. Common bile duct measures 3 mm in caliber.PANCREAS: Normal echogenicity of the visualized pancreas.SPLEEN: Normal echogenicity of the spleen measuring 13.7 cm. Accessory splenule is noted measuring 1.4 cm x 1.5 cm x 1.3 cm.RIGHT KIDNEY: Enlarged measuring 18.4 cm in length. Renal parenchyma is replaced by innumerable cysts, some of which are complex appearing with internal debris.OTHER: Left kidney is also enlarged measuring 16.5 cm in length. Renal parenchyma is also replaced by innumerable cysts, some of which are complex appearing with internal debris.Left pleural effusion.
1. Gallbladder wall thickening cholelithiasis with no pericholecystic fluid. This may be related to heart disease or renal failure.2. Mild intrahepatic biliary ductal dilatation, with normal caliber of the common bile duct however.3. Left pleural effusion. 4. Bilateral innumerable renal cysts, some of which are complex and contain internal debris. 