Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 20 cm in length. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Several subcentimeter gallstones noted. The gallbladder is collapsed, which limits evaluation for wall thickening. Trace pericholecystic fluid is nonspecific in the setting of liver dysfunction. Negative sonographic Murphy's sign reported.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.8 cm in length. The left kidney is 10.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 10.6 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted.
1. Cholelithiasis without specific evidence of cholecystitis. Trace pericholecystic fluid present, nonspecific in the setting of liver dysfunction. The gallbladder is collapsed, which limits evaluation. Negative sonographic Murphy's sign reported. If further clinical suspicion for cholecystitis persists, nuclear medicine HIDA scan may be helpful.2. Increased hepatic echogenicity, compatible with parenchymal dysfunction.