Evaluate for possible acalculus cholecystitis in a patient with neutropenic fever, septic shock LIVER: Liver measures 23.6 cm, severely echogenic. No specific hepatic lesions noted. Smooth contour of the liver noted. Main portal vein demonstrates normal flow directionality and patency. No intrahepatic biliary ductal dilatation.BILIARY TRACT: Common bile duct measures up to 5 mm. Gallbladder is well-distended with multiple gallstones within it. Gallbladder wall is thickened and measures 6 mm. No evidence of pericholecystic fluid noted.PANCREAS: Cannot be visualized due to overlying bowel gas.SPLEEN: Spleen measures 13 cm, mildly increased in size, without any focal lesions.RIGHT KIDNEY: Right kidney measures 12.3 cm left kidney measures 13 cm. No renal stones or focal lesions or hydronephrosis noted. Normal echotexture noted. OTHER: No ascites
Distended gallbladder with gallstones within it and increased gallbladder wall thickening in comparison with prior examination suspicious for acute cholecystitis. No definite pericholecystic fluid noted.Mild splenomegaly.Mild hepatomegaly with fatty infiltration.