Reason: Evaluate for cholecystitis, biliary ductal dilation, also kidney injury History: concern for acute pancreatitis and acute renal failure LIVER: The liver measures 17.3 cm in length. The liver parenchymal echotexture is normal. There are several cystic structures within the liver, some of which contain mildly thickened internal septations. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.16 m/s.BILIARY TRACT: Contracted gallbladder. Cholelithiasis. Gallbladder wall thickening which is nonspecific in the setting of ascites. The sonographic Murphy's sign is negative. No intrahepatic biliary ductal dilatation is present. The common hepatic duct measures 7.6 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: Poorly visualized.RIGHT KIDNEY: Poorly visualized. Kidney measures 9.9 cm in length. No frank hydronephrosis.LEFT KIDNEY: Poorly visualized. Kidney measures 10.2 cm in length. No frank hydronephrosis.ABDOMINAL AORTA: Proximal aorta within normal limits. Middle and distal aorta obscured.INFERIOR VENA CAVA: No gross abnormality, though poorly visualized.OTHER: Mild abdominal ascites. Pleural effusions. Bladder collapsed with Foley.
1.Contracted gallbladder with cholelithiasis and wall thickening which is nonspecific in the setting of ascites. Acute cholecystitis cannot be excluded on the basis of the study. Correlation with laboratory values and clinical history is recommended. Nuclear medicine HIDA scan can be considered for additional evaluation as warranted.2.Abdominal ascites and pleural effusions.3.No frank hydronephrosis.