Evaluate for fatty liver. LIVER: The liver is mildly coarse and echogenic. It measures 15.6 cm in length without a focal lesion or intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 36 cm/s. The common hepatic duct measures 6 mm.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Common hepatic duct measures 6 mm, within normal limits. The common bile duct is obscured by overlying bowel gas.Distended gallbladder is noted with suspected wall echo shadow sign indicating multiple gallstones filling the lumen. This is favored over diffuse gallbladder wall calcification/porcelain gallbladder as some images demonstrate a small amount of fluid between the wall and echogenic shadowing gallstones. No significant wall thickening pericholecystic fluid or focal tenderness.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 7.5 cm and is suboptimally visualized.RIGHT KIDNEY: The right kidney measures 10.5 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 12.7 cm in length without hydronephrosis. 1.6 cm echogenic shadowing probable nonobstructive calculus. 4.0 x 3.6 cm anechoic lesion with a thin septation, likely a minimally complex cyst.
Coarse and echogenic liver parenchyma may be seen in parenchymal dysfunction and/or fatty liver.The gallbladder is likely full of gallstones without specific findings of gallbladder inflammation. This is favored over a porcelain gallbladder as described above.4.0 cm minimally complex left renal cyst. 1.6 cm left renal probable nonobstructive calculus.