79-year-old male with elevated bilirubin, AKI. Evaluate for causes of elevated LFTs and AKI. LIVER: Normal echogenicity of the liver measuring 18.3 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 14.7 cm/sec.GALLBLADDER, BILIARY TRACT: Sludge within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common bile duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 10.5 cm in length.KIDNEYS: Thinned echogenic right kidney measuring 10.1 cm in length. No hydronephrosis or shadowing calculus are noted.Thinned echogenic left kidney measuring 9.9 cm in length. No hydronephrosis or shadowing calculus are noted.ABDOMINAL AORTA: The midabdominal aorta measures 2.2-cm x 2.9 cm x 2.5 cm. No evidence of aneurysm.INFERIOR VENA CAVA: The visualized IVC is normal in caliber with appropriate directional flow.OTHER: Foley catheter within a decompressed bladder limits evaluation.
1. Thinned echogenic kidneys bilaterally suggestive of parenchymal dysfunction. 2. Sludge within the gallbladder. No evidence of cholecystitis. 