Leukocytosis, right upper quadrant pain, evaluate for cholecystitis LIVER: Liver measures 16.7 cm with heterogenous echotexture. No focal lesions noted within the liver. No intrahepatic biliary duct dilatation.Main portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is distended with multiple gall stones in the neck, body and fundus region. Gallbladder wall thickening is predominantly noted in the region of the fundus measuring up to 5 mm. The fundal wall thickening with multiple small hyperechoic areas, few of which demonstrate shadowing suggesting stones and few demonstrate ringdown artifact suggestive of underlying fundal adenomyomatosis.No evidence of pericholecystic fluid noted. Sonographic Murphy sign is positive.Common bile duct is nondilated measures up to 4 mmPANCREAS: Part of the head of the pancreas as visualized appears unremarkable. Body and tail of pancreas not visualized.SPLEEN: Spleen is not visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney measures 11.7 cm and left kidney measures 10.9 cm. Both kidneys are mildly echogenic suggesting underlying parenchymal disease. Multiple small septated cyst identified in the lower pole of the right kidney, largest measuring 5 x 4 x 3.1 cm. OTHER: No ascites
Cholelithiasis with gallbladder wall thickening and sonographic Murphy's sign positive suggestive of acute cholecystitis. Focal fundal findings suggestive of fundal adenomyomatosis.Spleen is not visualized due to overlying bowel gas.No ascitesRight lower pole septated cyst.