76-year-old female with a history of hepatitis C presents for evaluation of liver. LIVER:Measures 4.6 cm. There is increased and coarse echogenicity of the parenchyma. No focal mass or ascites. There is a dirty shadowing arising from the biliary system, consistent with pneumobilia.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. As above, there is dirty shadowing arising from the biliary system consistent with pneumobilia. The common bile duct measures 5.1 mm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 6.7 cm without sonographic abnormalities. Of note, much of the spleen is shadowed out.KIDNEYS: Right kidney measures 8.5 cm. Left kidney measures 8.0 cm. The kidneys are echogenic bilaterally. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted.
1. Coarse echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No mass or ascites.2. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction. No hydronephrosis.3. There is dirty shadowing arising from biliary system consistent with pneumobilia, which was also seen on prior CT.4. Surgical changes of a prior cholecystectomy.