Reason: assess for cholecystitis vs. Perinephric abscess History: fever, gram negative bacteremia on antibiotics. LIVER: The liver measures 17.5 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s.BILIARY TRACT: Cholelithiasis without associated gallbladder wall thickening or pericholecystic fluid. Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2.6 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 8.8 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Increased cortical echogenicity. No hydronephrosis. Heterogeneous complex cystic lesion in the right midpole pole measures 1.7 x 1.6 x 1.8 cm, previously 2.4 x 1.8 x 1.9 cm. The previously seen complex lesion in the right upper pole is not well seen on today's examination.LEFT KIDNEY: Kidney measures 11.0 cm in length. Increased cortical echogenicity. No hydronephrosis. In the left lower pole, there is a thinly septated cyst measuring up to 1.2 cm, not significant changed.ABDOMINAL AORTA: Proximal aorta measures 2.4 x 2.2 cm. The middle aorta measures 1.9 x 2.1 cm. Distal aorta measures 2.3 x 2.1 cm. Atherosclerotic disease. Focal areas of ectasia better appreciated on recent CT.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Foley catheter within the bladder.
1.Cholelithiasis without sonographic evidence of cholecystitis.2.Complex right renal midpole lesion appears similar to 12/9/2016 exam. Previously seen right upper pole lesion not well visualized on today's examination. Repeat dedicated multiphasic cross-sectional imaging should be considered for additional evaluation. No perinephric fluid collections identified.3.Echogenic kidneys suggestive of medical renal disease.