30-year-old male presents with epigastric pain. There is clinical concern for cholelithiasis and cholecystitis. LIVER:Measures 17.2 cm. Mildly increased echogenicity. No focal mass, ascites, intrahepatic biliary dilation portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. Wall measures 0.2 cm. Common bile duct measures 0.2 cm. Echogenic dependent material within the lumen of the gallbladder consistent with gallbladder sludge. No stones or pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: Evaluation of the gallbladder is limited due to overlying bowel gas.SPLEEN: Measures 9.4 cm without sonographic abnormalities.KIDNEYS: Right kidney is 12.3 cm. Left kidney is 12.8 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted.
1. Increased hepatic echogenicity consistent with fatty infiltration and chronic liver disease/parenchymal dysfunction. No mass or ascites.2. Gallbladder sludge without evidence of cholelithiasis or cholecystitis.