Female 46 years old Reason: eval for cholelithiasis History: abdominal pain, elevated Tbili and alk phos Exam is limited by patient's inability to change position.LIVER: Coarsened echogenicity of the liver, which can be seen in the setting of fatty infiltration. Liver capsule appears smooth. Liver measures 18.3 cm in length. Main portal vein is patent with normal directional flow and peak velocity of 27.8 cm/s. Hypoechoic area adjacent to the gallbladder may be an area of focal fat sparingBILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Common bile duct measures up to 2 mm. Gallbladder wall is within normal limits measuring up to 3 mm. No shadowing stones are present in the gallbladder.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: Spleen is within normal limits measuring 9.2 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.1 cm. Left kidney measures 9.3 cm. OTHER: No significant abnormalities noted.
1.No evidence of cholelithiasis or abnormal biliary ductal dilatation.2.Coarsened echogenicity of the liver is nonspecific but can suggest fatty infiltration or be seen in diffuse hepatic dysfunction.