77 years old, Male, Reason: hx of pancreatic ca and AAA now w/ fever, chills, RUQ pain, leukocytosis; eval for acute cholecystitis History: fever, RUQ pain LIVER: The liver is enlarged measuring 19.7 cm in length. Parenchymal echogenicity is within normal limits. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: Gallbladder stones and sludge are present. Marked gallbladder wall thickening and pericholecystic fluid with surrounding inflammatory changes. Findings compatible with acute cholecystitis. Mild intrahepatic biliary ductal dilatation. The common bile duct measures 6 mm in diameter. Biliary stent is not well visualized on this exam.PANCREAS: Marked pancreatic ductal dilatation measuring up to 9 mm. Patient's pancreatic tumor is not well visualized, please refer to abdominal CT of the same date.SPLEEN: No significant abnormalities noted. The spleen measures 12.6 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 10.5 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted.
1.Findings consistent with acute cholecystitis.2.Marked pancreatic ductal dilatation related to known pancreatic cancer.3.Mildly increased echogenicity of the kidneys consistent with medical renal disease.