Reason: 86M w abdominal pain, nausea, vomiting x1, bacteremia of unclear source, elevated LFTs LIVER: The liver measures 13.4 cm in length. Echogenic hepatic parenchyma. The main portal vein is patent with normal directional hepatopedal blood flow, peak velocity 25.4 cm/s.GALLBLADDER, BILIARY TRACT: There is amorphous adherent intraluminal debris and irregular circumferential gallbladder wall thickening up to 3 mm without gallbladder wall vascularity. There is intrahepatic biliary ductal dilatation. The distal common bile duct measures 0.5 cm. No pericholecystic fluid or shadowing stones. Negative sonographic Murphy's sign. PANCREAS: No significant abnormalities noted. The body and tail are obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 8.0 cm in length. The left kidney measures 9.8 cm in length. Echogenic renal parenchyma. Trace perinephric fluid. No hydronephrosis or shadowing stones.OTHER: The spleen measures 7.9 cm. There is trace perisplenic fluid. Mildly enlarged prostate.
1. Irregular gallbladder wall thickening and/or sludge as described above with intrahepatic biliary ductal dilatation. MRCP is recommended for further evaluation.2. Findings consistent with hepatic steatosis or parenchymal dysfunction.3. Findings consistent with medical renal disease.