Right upper quadrant pain. Pancreatic mass. Status post ERCP. LIVER: Diffusely heterogeneous parenchymal echogenicity with focal lesions suggestive of metastatic disease. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: The biliary ductal dilation is markedly decreased status post stent placement. Cholelithiasis. No gallbladder wall thickening or sonographic Murphy's sign.PANCREAS: Pancreatic head prominence compatible with the patient's known pancreatic head mass is partially visualized due to overlying bowel gas. KIDNEYS: The right kidney is 6.0 cm in length. The left kidney is 5.8 cm in length. The renal parenchyma is markedly echogenic. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 8.3 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted.
1. Decreased biliary ductal dilation status post stent placement.2. Cholelithiasis without specific evidence of cholecystitis.3. Diffusely heterogeneous liver lesions suggestive of metastatic disease.4. Diminutive kidneys with echogenic renal parenchyma, compatible with chronic renal disease.