Male; 38 years old. Reason: cholecystitis? History: ct evidence pericholecystic fluid, abd pain LIVER: The liver measures 16.1 cm in length. The liver surface is smooth, the parenchyma is diffusely heterogeneous. In the right lobe of the liver is a 2.1 x 2.2 x 1.9 cm hyperechoic lesion without vascularity on color Doppler. This correlates with the lesion seen on same day CT. There is a moderate amount of ascites.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: There is no cholelithiasis. The gallbladder wall is thickened measuring up to 7 mm. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas has a lobulated appearance correlating with the appearance on the two prior CTs from February 2015. The body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: The spleen measures 14.1 cm in length.KIDNEYS: The right kidney measures 11.9 cm in length, the left kidney measures 12.1 cm in length. The cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone.OTHER: Note is made of bilateral pleural effusions.
1.Thickened gallbladder wall is likely secondary to ascites. There is no cholelithiasis or other evidence of acute cholecystitis.2.2.2-cm hyperechoic lesion in the right lobe of the liver is indeterminate. Continued follow-up is recommended. Alternatively, correlation with MRI may be considered if clinically warranted.3.Splenomegaly.4.Moderate amount of ascites.5.Bilateral pleural effusions.