22-year-old female with fever, elevated AST/ALT, alkaline phosphatase. Evaluate causes of abnormal LFT. LIVER: The liver is enlarged measuring 20.1 cm in length and is normal in echogenicity with no focal hepatic lesions. No intrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Focal echogenic focus along the gallbladder wall with comet tail artifact compatible with focal adenomyoma. No sludge or gallstones. No pericholecystic fluid. Sonographic Murphy's sign is negative. No extrahepatic biliary ductal dilatation. The common duct measures 2 mm in caliber.PANCREAS: The distal body and tail of pancreas are obscured by overlying bowel gas. The remaining visualized pancreas is normal in echogenicity. No pancreatic ductal dilatation.RIGHT KIDNEY: The right kidney measures 11.5 cm in length with no hydronephrosis or nephrolithiasis. OTHER: The left kidney measures 11.9 cm in length with no hydronephrosis or nephrolithiasis. The spleen measures 12.4 cm in length, upper limits of normal.
1. Hepatomegaly and borderline splenomegaly.2. Focal adenomyoma along the gallbladder wall.