Right upper quadrant pain, evaluate for cholecystitis. LIVER: The liver measures approximately 16 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: Cholelithiasis with layering stones in the gallbladder neck. Additional adherent stone versus 5 mm polyp along fundus wall. Equivocal gallbladder wall thickening. The sonographic Murphy's sign is negative, however, the patient recently received pain medications. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.4 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted.
Cholelithiasis. Equivocal gallbladder wall thickening which is nonspecific but could reflect early acute cholecystitis. Nuclear medicine HIDA scan can be considered for further evaluation if clinically warranted.