50-year-old male presents with hyperbilirubinemia. Evaluate for biliary pathology. LIVER:The liver measures 18.7 cm in length. The parenchyma appears coarse and echogenic. No intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow. Mild ascites.GALLBLADDER, BILIARY TRACT: There are multiple subcentimeter echogenic foci in the gall bladder, the largest measuring approximately 0.6 x 0.4 x 0.7 cm, that are nondependent and are consistent with gallbladder polyps. Negative Murphy sign. The gallbladder wall measures 0.4 cm. There is no pericholecystic fluid. The common bile duct measures 5.6 mm.PANCREAS: Evaluation the pancreas is limited by overlying bowel gas, however the visualized portions appear normal.SPLEEN: The spleen measures 16.7 cm.KIDNEYS: The right kidney measures 11.2 cm and the left kidney measures 11.7 cm. The kidneys appear atrophic. No shadowing calculi, mass, or hydronephrosis. OTHER: No significant abnormality noted.
1. Coarse and echogenic liver consistent with chronic liver disease/parenchymal dysfunction. There is mild ascites, but no mass.2. Atrophic and echogenic kidneys consistent with chronic renal disease/parenchymal dysfunction.3. Gallbladder polyps without signs of acute cholecystitis or ductal dilatation.4. Hepatosplenomegaly.