74-year-old male presents with sepsis and elevated AST/ALT and bilirubin. Evaluate for biliary source of infection. LIVER: Increased echogenicity in the liver, which is nonspecific, but can be seen in hepatic steatosis. Hepatomegaly. The liver measures 19.9 cm in length. The portal vein flow is hepatopetal.GALLBLADDER, BILIARY TRACT: Note is made of multiple punctate shadowing dependent gallstones. No evidence of acute cholecystitis. Sonographic Murphy sign is negative. No common duct stones are seen.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Note is made of a 12-mm shadowing nonobstructing renal calculus in the inferior pole of the right kidney.OTHER: No significant abnormalities noted.
1. Increased echogenicity in the liver, which is nonspecific, but can be seen in hepatic steatosis.2. Hepatomegaly. 3. Gallstones without evidence of acute cholecystitis.4. 12-mm nonobstructing renal calculus in the inferior pole of the right kidney.