58-year-old male with transaminitis. Evaluate for liver pathology or portal vein thrombosis. Limited study due to patient body habitus.LIVER: Increased echogenicity of the liver measuring 15.9 cm in length. No focal hepatic lesions. The main portal vein is patent with appropriate directional flow: Peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Sludge within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Cannot assess for sonographic Murphy's sign. Common duct is obscured due however there is no intrahepatic biliary ductal dilatation noted. PANCREAS: Obscured by overlying bowel gas.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 11.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 14.2 cm in length.Normal echogenicity of the left kidney measuring 10.6 cm in length. No hydronephrosis or shadowing calculi are noted.
Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Portal vein is patent.Sludge within the gallbladder with no sonographic evidence of cholecystitis.