61 years old, Female, Reason: eval for cholecystisis History: RUQ pain LIVER: The liver is enlarged measuring 18.6 cm in length. Mildly increased echogenicity of the liver is consistent with fatty infiltration.No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.5 m/s.BILIARY TRACT: The gallbladder is filled with sludge and stones. There is thickening of the gallbladder wall measuring up to 5 mm. Trace pericholecystic fluid is present. A stone is seen in the neck of the gallbladder which may be obstructing. The sonographic Murphy's sign is positive. The gallbladder itself is enlarged measuring up to 12.9 cm. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4.4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 6.5 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.2 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted.
1.Findings suggestive of acute cholecystitis in the appropriate clinical setting.These findings were discussed with ordering physician Dr. Turk at 11 a.m. who agreed patient should be sent to the emergency room. Discussed this with the patient who agreed to go straight to emergency room.