75-year-old female with right upper quadrant pain. Evaluate for biliary pathology. Of note, the exam is limited by patient's inability to hold breath during the exam and due to bowel gas.LIVER:The liver measures approximate 14.7 cm. There is coarse, increased, and heterogeneous echotexture of the parenchyma. No mass or ascites noted. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended and the wall measures 0.1cm. There is a negative Murphy's. No stones or sludge seen. No pericholecystic fluid. The common bile duct measures 3.3 mm.PANCREAS: Evaluation of the pancreas is limited due to overlying bowel gas.SPLEEN: The spleen measures 7.7 cm. No significant abnormality noted.KIDNEYS: The right kidney measures 10.4 cm. There is a round anechoic area with posterior acoustic enhancement measuring approximately 2.2 x 2.3 x 3.1 cm that is consistent with a simple cyst. No concerning mass or shadowing calculi. No hydronephrosis. The left kidney measures 9.4 cm. There is a round anechoic area with posterior acoustic enhancement measuring approximately 2.3 x 2.1 x 1.9 cm and is consistent with a simple cyst. No concerning mass or shadowing calculi. No hydronephrosis. The kidneys appear atrophic bilaterally. OTHER: No significant abnormality noted.
1. Coarse and echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No ductal dilatation, mass, or ascites.2. Atrophic kidneys consistent with chronic medical renal disease/parenchymal dysfunction.3. No evidence of cholelithiasis or gallbladder disease.