Male 61 years old Reason: Assess for cholecystitis, cholelithiasis History: RUQ abdominal pain, nausea, vomiting LIVER: Liver echogenicity is increased. Hepatic veins and IVC are dilated. There is small amount of perihepatic ascites. Common bile duct measures 6 mm, normal.BILIARY TRACT: No evidence of intra or extrahepatic biliary dilatation. Gallbladder is distended with sludge and stones. There is gallbladder wall thickening and small amount of pericholecystic fluid. These findings can be compatible with acute cholecystitis despite the lack of sonographic Murphy's sign.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 11.5 cm.RIGHT KIDNEY: Right kidney measures 10.4 cm. Left kidney measures 12 cm. No evidence of hydronephrosis. OTHER: No significant abnormalities noted.
Cholelithiasis with distended gallbladder and gallbladder wall thickening. These findings may be compatible with acute cholecystitis.Heterogeneous echotexture of the liver. Correlate with clinical liver function tests. Dilated IVC and hepatic veins and small amount of hepatic ascites. These may be secondary to congestive heart failure.