Evaluate for cholecystitis LIVER: Liver measures 21.8 cm, increased in size with diffuse increased echogenicity suggestive of fatty infiltration. Echotexture appears mildly coarse. Multiple bilobar hypoechoic solid-appearing lesions are identified throughout the liver, some of them appears subcapsular in location, reference lesion measures 2.2 x 1.7 cm in the right lobe with no definite flow on Doppler imaging.Portal vein appears patent.GALLBLADDER, BILIARY TRACT: Distended gallbladder without gallstones. Sonographic Murphy sign is negative. No gallbladder wall thickening or pericholecystic fluid.PANCREAS: Not well visualized due to overlying bowel gas.KIDNEY: No evidence of renal stones or hydronephrosis.OTHER: Spleen measures 9.2 cm appears unremarkable
Hepatomegaly with diffuse coarse echotexture. Bilobar hepatic somewhat solid appearing lesions. Differential is a large spectrum including metastasis disease or infectious/inflammatory process. Further evaluation with liver CT protocol is recommended.Distended gallbladder without cholecystitis