75-year-old female with a cholangiocarcinoma presents with gram negative bacteremia and septic shock. Evaluate biliary system. LIVER: Measures 19.3 cm. Coarse heterogenous echotexture of liver noted. Previously noted biliary stent is partially visualized. Area in the left hepatic lobe may have some biliary dilation. No definite ductal dilatation and the common hepatic duct measures approximately 0.5 cm. No mass or ascites. Portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. The common bile duct is not definitely visualized on this study.PANCREAS: Evaluation the pancreas limited due to overlying bowel gas.SPLEEN: The spleen measures 11.7 cm without sonographic abnormalities.KIDNEYS: The right kidney measures 12.1 cm. Left kidney measures 10.5 cm. The kidneys have normal echogenicity. No hydronephrosis, focal mass, or shadowing calculi. OTHER: No fluid collections are seen.
1. Coarse heterogenous echotexture of liver consistent with chronic liver disease/parenchymal dysfunction2. No definite ductal dilatation however there is a questionable area in the left hepatic lobe that may have some minimal ductal dilatation related to known cholangiocarcinoma.