Evaluate for biliary distention, jaundice LIVER: Liver measures 18.2 cm appears coarse, heterogenous, with nodular surface, and perihepatic fluid noted. Irregular hypoechoic area in the right lobe of the liver near the dome is identified that measures 1.2 x 0.9 cmFoci of air artifact are present in the biliary system with intrahepatic biliary ductal dilatation. Stent visualized in the common bile duct.Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is mildly distended with few gallstones within it. Irregular septated heterogenous appearance of the gallbladder is noted. Gallbladder wall is thickened. PANCREAS: In the region of the head of the pancreas heterogenous hypoechoic mass is identified. Pancreatic duct does not appear to be dilated. Limited evaluation of the pancreatic head mass due to overlying bowel gas.SPLEEN: Spleen measures 11.9 cm without any focal lesions.RIGHT KIDNEY: Both kidneys measure 11 cm, normal echotexture. No hydronephrosis or hydroureter. No focal lesions noted.OTHER: Moderate ascites noted.
1. Coarse heterogenous echotexture of the liver with perihepatic fluid. Stent noted within the common bile duct with mild intrahepatic biliary ductal dilatation and pneumobilia.2. Indeterminate hypoechoic area in the right lobe of liver for which cross-sectional CT liver protocol is recommended for further evaluation.3. Distended gallbladder with septations heterogenous appearance with wall thickening suspicious of an infiltrative neoplastic process versus acalculous cholecystitis.4. Moderate ascites5. Pancreatic head mass is incompletely evaluated.