48-year-old female patient with rising bilirubin. Concern for obstruction. LIVER: The liver measures 17.9 cm in length and mildly nodular in contour. Redemonstration of a hyperechoic region within segment IV of the liver which corresponded to fat on prior MRI. A right hepatic dome lesion is not seen on this examination. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is sludge within the gallbladder. The gallbladder wall is borderline thickened measuring approximately 4 mm in diameter, which is nonspecific in the setting of ascites. An echogenic focus in the gallbladder which likely reasons a polyp measures 0.5 x 0.4 x 0.5 cm. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 14.0 cm in length and demonstrate increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 14.1 cm in length and demonstrate increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 25.2 cm in length.There is mild ascites.
1. Cirrhotic morphology of the liver with mild ascites and splenomegaly.2. Biliary sludge with non-specific gallbladder wall thickening in the setting of ascites.3. Subcentimeter gallbladder polyp.4. Medical renal disease.