Right upper quadrant pain. LIVER: The liver measures 24.6 cm in length. The background liver parenchymal echotexture is normal. There are several focal hypoechoic lesions within the liver some of which demonstrate a targetoid appearance. An example lesion within the left lobe measures 2.1 x 1.9 x 1.6 cm. There are also multiple cystic structures primarily in the right lobe of the liver several of which contain fine internal septations. The largest cystic structure is in the right lobe measuring 7.9 x 9.0 x 12.0 cm. The portal vein is patent demonstrating normal hepatopetal flow with an elevated velocity of 0.64 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. There is a non-shadowing, nonmobile structure along the body of the gallbladder wall measuring up to 8 mm which lacks internal vascularity and is compatible with a polyp. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.5 cm in length. RIGHT KIDNEY: Kidney measures 12.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.2 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted.
1.Several hypoechoic hepatic lesions, which are nonspecific but could reflect metastases. Dedicated cross-sectional imaging of the abdomen and pelvis with intravenous contrast is recommended for further characterization.2.Mildly increased flow velocity in the main portal vein which is nonspecific but which could suggest narrowing.3.Several hepatic cysts.4.No evidence of acute cholecystitis or biliary ductal dilatation.5.8 mm gallbladder polyp, continued surveillance is recommended.Findings discussed with ordering ER physician at 2:14 PM on 11/21/2016. 