Right upper quadrant pain with stones on bedside ultrasound and positive Murphy's sign. LIVER: The liver is coarse and echogenic. It measures 21 cm in craniocaudal dimension without a focal suspicious lesion or intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 0.4 m/s.Cholelithiasis with gallstone at the gallbladder neck which did not appear to be mobile. The gallbladder wall is mildly thickened measuring up to 4 mm with pericholecystic fluid. The patient was tender over the gallbladder fossa.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 6 mm.PANCREAS: The pancreas is mostly obscured by overlying bowel gas.SPLEEN: The spleen is normal in morphology and size measures 11 cm without a focal lesion.RIGHT KIDNEY: The right kidney is normal in size and morphology measuring 11.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney is normal in morphology and size measuring 10.3 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow.
1. Findings compatible with acute cholecystitis with cholelithiasis, gallbladder wall thickening, pericholecystic fluid and focal tenderness.2. The common bile duct measures up to 6 mm without choledocholithiasis.3. Hepatic steatosis.