64-year-old female patient with fever, distended abdomen, critical illness. Evaluate for acalculus cholecystitis. LIVER: The liver measures 17.6 cm in length and demonstrates increased hepatic parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones. The gallbladder is mildly dilated. There is no significant gallbladder wall thickening or pericholecystic fluid.. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 6 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 10.5 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.6 cm in length. No evidence of hydronephrosis.The spleen measures 8.9 cm in length.Bilateral pleural effusions are noted.
1. Cholelithiasis with mildly dilated gallbladder but no sonographic findings of acute cholecystitis.2. Increased hepatic parenchymal echogenicity which can be seen with hepatic steatosis/hepatic parenchymal dysfunction.3. Bilateral pleural effusions.