Rule out cholelithiasis right flank pain with radiation to right shoulder Suboptimal scan, large body habitus making penetration and visualization of structures difficult.LIVER: Liver measures 16.9 cm with moderate increased echogenicity consistent with hepatic steatosis. No focal lesions noted within the liver.No intrahepatic biliary ductal initiation. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Common bile duct at the porta measures up to 4 mm. Gallbladder is well-distended without any focal lesions or gallstones. No evidence of pericholecystic fluid. Sonographic Murphy sign is negative.PANCREAS: Not visualized due to overlying bowel gasSPLEEN: Spleen measures 8.2 cm, partially visualized due to patient body habitus and overlying bowel gasKIDNEY: Right kidney measures 12.6 cm and left kidney measures 11.3 cm. Both kidneys demonstrate cortical thinning and increased echogenicity suggestive of chronic medical renal disease. Nonobstructing left renal calculus in the midpole measuring up to 5 mm is redemonstrated.OTHER: No ascites
Bilateral echogenic kidneys consistent with chronic medical renal disease.Hepatic steatosis.No evidence of acute cholecystitis or cholelithiasis.Nonobstructing left renal calculus which is unchanged from prior examination.