81-year-old male with Escherichia coli sepsis, anuric. RIGHT KIDNEY: Measures 11.1 cm in length. Markedly increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 11.2 cm in length. Markedly increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Collapsed with a Foley catheter in place.OTHER: 12.1 x 10.4 x 8.9 cm complex collection noted in the left upper quadrant, which in retrospect was present on recent CT from 9/7/2015 however was very difficult to visualize at that time given anasarca and appears retroperitoneal in location.Bilateral pleural effusions.
1. Large complex left retroperitoneal collection as described above, for which there is a wide differential diagnosis including hematoma and/or abscess, additionally a neoplasm cannot be excluded. Correlation with a contrast enhanced cross sectional study is recommended as feasible clinically. 2. Markedly increased renal echogenicity consistent with medical renal disease. 3. Bilateral pleural effusions. Findings discussed with Dr. Gregory Haman at 1100 on 9/9/15. 