Right upper quadrant and epigastric pain. Elevated lipase, alkaline phosphatase and AST. LIVER: The liver is coarse and echogenic with mild posterior shadowing. No focal lesion is evident. It measures 18.3 cm in length. No intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 28 cm/s.BILIARY TRACT: The common duct measures 4 mm. Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: The pancreatic head is partially imaged without a discrete abnormality. The remainder of the pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 6.6 cm in length without a focal lesion.RIGHT KIDNEY: The right kidney measures 11.2 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow.
Coarse echogenic liver most commonly seen in diffuse fatty infiltration.No biliary ductal dilatation, gallstones or evidence of acute cholecystitis. Limited evaluation of the pancreas.