Reason: 58 yo F with newly diagnosed colon cancer with metastases to liver now having fever, evaluate for biliary digitation History: fever, abdominal pain LIVER: The liver is enlarged and measures 20.8 cm in length. Innumerable predominantly hyperechoic hepatic lesions in both lobes compatible with metastatic disease. Additional scattered hepatic cysts of varying sizes. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.22 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 9.2 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: Abdominal ascites. Bilateral pleural effusions, increased from recent CT.
1.Diffuse hepatic metastatic disease.2.No evidence of acute cholecystitis or biliary ductal dilatation.3.Ascites. Increasing bilateral pleural effusions.