Reason: RUQ pain with elevated LFTs, assess for cholecystitis LIVER: The liver measures approximately 15.2 cm in length. Pneumobilia and intrahepatic biliary ductal dilation again seen, similar to recent CT. The main portal vein is patent with apparently elevated hepatopetal flow, peak velocity 164.2 cm/s. Echogenic internal biliary stent is partially visualized.GALLBLADDER, BILIARY TRACT: Echogenic sludge within the dependent portion of the gallbladder. No shadowing stones are identified. No pericholecystic fluid or inflammation. Negative sonographic Murphy's sign. The gallbladder wall measures 0.2 cm and the common bile duct measures 0.2, although the common bile duct stent is not visualized.PANCREAS: No significant abnormalities noted.KIDNEYS: The right kidney measures 11.4 cm in length. The left kidney measures 12.1 cm in length. Bilaterally echogenic renal parenchyma. The proximal portions of bilateral nephroureteral stents are visualized with mild residual hydronephrosis bilaterally. No shadowing renal calculi.OTHER: Mild to moderate volume ascites. The spleen measures 11.6 cm in length.
1. Gallbladder sludge without evidence of acute inflammation. Negative sonographic Murphy's sign.2. Persistent pneumobilia and intrahepatic biliary ductal dilatation, similar to prior CT.3. Bilateral echogenic renal parenchyma, consistent with medical renal disease.4. Mild bilateral hydronephrosis.5. Mild to moderate volume ascites.