63 year old female with right upper quadrant pain. Evaluate for biliary or hepatic pathology. LIVER: Coarse echogenicity of the liver measuring 19.4 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY TRACT: Sludge and small echogenic foci likely stones within the gallbladder. Gallbladder wall thickening of the 4 mm nonspecific in the setting of ascites. No pericholecystic fluid. Sonographic Murphy's sign is negative. No intra-or extrahepatic delayed ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal in echogenicity. No pancreatic ductal dilatation.RIGHT KIDNEY: Not well assessed with diffusely increased echogenicity. Cyst at the upper pole measures 3.8 cm x 3.3 cm x 3.0 cm.OTHER: Left kidney not well seen, however is increased in echogenicity. Normal echogenicity of the spleen measuring 11.47 m in length.
1. Sludge and likely small stones within the gallbladder with gallbladder wall thickening which is nonspecific in the setting of ascites. Sonographic Murphy's sign is negative.2. Diffusely increased echogenicity of the kidneys which are difficult to visualize suggestive of parenchymal dysfunction. Right renal cyst not significantly changed. 3. Enlarged and coarse echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. 