Reason: Evaluate for gallstones, liver parenchyma History: Acute pancreatitis, elevated transaminases LIVER: The liver measures 14.7 cm in length. Coarse, heterogeneous hepatic parenchyma. The portal vein is patent with normal directional hepatopedal blood flow, peak velocity 20.5 cm/s. No focal masses.GALLBLADDER, BILIARY TRACT: The gallbladder is distended with layering intraluminal sludge. No shadowing stones. The gallbladder wall measures 0.1 cm. The proximal common bile duct measures 0.2 cm. The distal common bile duct is obscured by bowel gas. No intrahepatic or extrahepatic biliary ductal dilatation. Negative sonographic Murphy's sign.PANCREAS: Obscured by bowel gas. The pancreatic duct measures 0.1 cm.KIDNEYS: The right kidney measures 10.5 cm in length. The left kidney measures 12.0 cm in length. No hydronephrosis or shadowing stones.OTHER: Moderate volume ascites.
1. Distended gallbladder with intraluminal sludge without evidence of cholecystitis.2. Moderate volume ascites.3. Findings consistent with hepatic parenchymal dysfunction or hepatic stenosis.