Male 73 years old; Reason: assessment for cause of pancreatitis? Gallstones History: pancreatitis LIVER: The liver measures 19.7 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. There is now intrahepatic ductal dilation is seen that was not present on the previous MRI abdomen. The main portal vein is patent with normal hepatopetal flow. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.6 mm at the superficial side, however, the deep wall is shadowed out. No stones are seen, however the WES sign is present suggestive of a gallbladder full of stones. This correlates to the prior MRI. No pericholecystic fluid. The common bile duct measures 0.14 mm in diameter. PANCREAS: Evaluation the pancreas is limited by overlying bowel gas.SPLEEN: The spleen measures 11.1 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. The cortex has normal echogenicity. No hydronephrosis or shadowing calculi. There is a mass seen in the hepatorenal space that is better characterized on the prior MRI.LEFT KIDNEY: The left kidney measures 12.8 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: There are small bilateral pleural effusions.
1. New mild intrahepatic biliary dilation not present on the prior MRI. This could be further evaluated with an MRCP if clinically warranted. No obvious cause was seen on the prior MRI.2. Cholelithiasis without evidence of acute cholecystitis, although the gallbladder is not fully visualized.3. Mass in the right hepatorenal space better characterized on prior MRI.