Evaluate for Nash Limited exam due to large body habitus.LIVER: Liver measures 17.9 cm with heterogenous coarse echotexture. Portal vein demonstrates normal flow directionality and patency. No focal lesions noted. No intrahepatic biliary ductal dilatation noted.BILIARY TRACT: Gallbladder is well-distended with one echogenic focus adhering to the gallbladder wall most likely representing polyp. No evidence of shadowing suggestive of gallstones.Gallbladder wall thickness is within normal limits. Sonographic Murphy sign is negative. No evidence of pericholecystic fluid.PANCREAS: No significant abnormality in the body of the pancreas, head and tail of pancreas is not visualized due to overlying bowel gas.SPLEEN: Spleen measures 12.2 cm without any focal lesions.KIDNEY: Right kidney measures 12.4 and left kidney measures 13.5 cm. Both kidneys demonstrate mild increased echogenicity suggestive of chronic medical renal disease. No hydronephrosis or focal lesion. OTHER: No ascites
1. Coarse heterogenous echotexture of the liver without any focal lesions.2. Gallbladder polyp without evidence to evidence of cholelithiasis or cholecystitis. Surveillance with ultrasound in 6 months is recommended.3. Mild increased echogenicity of the kidneys consistent with chronic medical renal disease.