64-year-old female patient with abdominal pain, emesis. Question of cholecystitis. LIVER: The liver measures 16.0 cm in length and demonstrates increased, heterogeneous echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is cholelithiasis without significant gallbladder wall thickening. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The pancreas is not visualized on this examination.RIGHT KIDNEY: The right kidney measures 8.3 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A right upper pole renal cyst measures 3.5 x 2.9 x 3.4 cm.OTHER: The left kidney measures 8.1 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A left lower pole cyst measures 2.6 x 2.8 x 2.6 cm.The spleen measures 10.1 cm in length.There is mild ascites.
1. Coarsened, increased hepatic echogenicity likely related to chronic liver disease without focal hepatic lesion identified.2. Cholelithiasis without sonographic evidence of acute cholecystitis.3. Mild ascites.4. Medical renal disease and bilateral renal cysts. 