Elevated LFTs. Evaluate for cholecystitis. Findings are limited by inability to reposition the patient and patient's inability to hold breath.LIVER: Non-cirrhotic liver morphology. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction. A 5 x 4 x 4 cm complex collection posterior to the left hepatic lobe is identified.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Mild gallbladder wall thickening, which may be seen in the setting of ascites. No cholelithiasis or sonographic Murphy sign.PANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney is 8.5 cm in length. The left kidney is 8.8 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 12.5 cm in length, without focal lesions evident.OTHER: Moderate amount of complex ascites identified, with septations.
1. Coarsened hepatic echogenicity compatible with parenchymal dysfunction, without biliary ductal dilation.2. Moderate amount of complex septated ascites.3. 5 cm complex collection posterior to the left hepatic lobe. This is nonspecific in appearance and may represent loculated septated ascites, hematoma, or abscess.4. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease.