81-year-old male with history of cholecystectomy, continued right upper quadrant and right lower quadrant pain. LIVER: Normal echogenicity of the liver measuring 19.7 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Mild intra-and extrahepatic biliary ductal dilatation is again seen. PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: The right kidney is atrophic and increased in echogenicity measuring 11.8 cm in length with moderate to severe hydronephrosis and debris worse when compared to prior CT dated 1/20/2015. No shadowing calculi are noted.OTHER: Left kidney is increased in echogenicity measuring 13.5 cm in length. Cyst in the midpole measures 2.5 cm x 3.6 cm x 2.6 cm. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 13.6 cm in length.
1. Increased renal echogenicity bilaterally suggestive of parenchymal dysfunction. The right kidney is atrophic with moderate to severe hydronephrosis and debris worse when compared to prior CT. No hydronephrosis in the left kidney. No evidence of nephrolithiasis bilaterally. 2. Mild intra and extrahepatic biliary ductal dilatation is again seen and appears stable. 