Female 38 years old; Reason: RUQ pain History: pain LIVER: The liver measures 14.0 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 26.9 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.4 mm. A shadowing echogenic foci is seen within the gallbladder and tumefactive sludge is seen. A positive sonographic Murphy's sign was present. No pericholecystic fluid. The common bile duct measures 3.2 mm in diameter. No common bile duct stones are visualized.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 12.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.
1. Cholelithiasis without overt sonographic evidence of acute cholecystitis. Due to the positive Murphy's sign, early or occult acute inflammation cannot be excluded. No ductal dilatation.2. The liver has increased echogenicity which is compatible with fatty infiltration/hepatocellular dysfunction.