82-year-old female with sepsis. Evaluate the liver and gallbladder. LIVER: The liver measures 14.2 cm in length. It is mildly coarse and echogenic. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. Normal hepatopetal portal venous blood flow at 23 cm/sec.GALLBLADDER, BILIARY TRACT: A normally distended gallbladder is present with mild diffuse wall thickening/pericholecystic fluid measuring 4.3 mm without gallstones. Evaluation for focal tenderness was limited due to the patient's decreased awareness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm.PANCREAS: The suboptimally visualized pancreatic body and head is grossly unremarkable.SPLEEN: The poorly visualized spleen measures 7 cm in length.KIDNEYS: The right kidney measures 9.6 cm in length without hydronephrosis. The left kidney measures 9.6 cm without hydronephrosis.ABDOMINAL AORTA: Only the proximal aorta is visualized and is not aneurysmally dilated, measuring 2.2 cm in AP dimension.INFERIOR VENA CAVA: The visualized inferior vena cava is patent.
1. Normally distended gallbladder with mild diffuse wall thickening/pericholecystic fluid. Evaluation for focal tenderness was unreliable given the patient's decreased awareness. Overall, there is no specific evidence of acute cholecystitis. If there is continued clinical concern, a HIDA scan may be considered.2. Coarse and mildly echogenic liver parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction. 