84 year old male with hyperbilirubinemia. The study was very limited as the patient did not want to lie flat and resisted the exam.LIVER: The liver is normal in morphology, echogenicity and size, measuring 13.2 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: A normally distended gallbladder is present with sludge but no wall thickening, pericholecystic fluid, or focal tenderness. The common duct measures 3 mm in caliber at the hilum, within normal limits.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable.SPLEEN: The spleen is poorly visualized.RIGHT KIDNEY: The right kidney measures 9.3 cm in length without hydronephrosis or shadowing calculus.OTHER: The left kidney is poorly visualized. Note is made of a moderate right pleural effusion.
1. Limited examination as described above without biliary ductal dilatation. 2. Biliary sludge without specific evidence of acute cholecystitis.3. At least moderate right pleural effusion.4. No right hydronephrosis. Non-visualized left kidney.