75-year-old female complains of right upper quadrant pain. Evaluate for hepatobiliary pathology. LIVER:Measures 15.4 cm. Mildly heterogenous parenchyma. No focal mass, ascites, or intrahepatic biliary dilation. Portal vein is patent with hepatopedal flow. An approximately 0.5 x 1.6 x 1.0 cm well-defined hypoechoic area adjacent to the liver likely represents a lymph node.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. Wall measures 0.3 cm. There are multiple dependent echogenic foci within the lumen, consistent with cholelithiasis. No pericholecystic fluid. Equivocal sonographic Murphy's sign. Common bile duct measures 10.0 cm.PANCREAS: Evaluation the pancreas limited due to overlying bowel gas.SPLEEN: Measures 9.4 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.7 cm. Left kidney measures 10.2 cm. Unremarkable echogenicity. No focal mass, hydronephrosis, or shadowing calculi. OTHER: No significant abnormality noted.
1. Cholelithiasis with equivocal Murphy's sign. Consider HIDA scan.2. Heterogenous echotexture of liver parenchyma consistent with chronic liver disease and fatty infiltration/parenchymal dysfunction. No focal mass or ascites.