Reason: Evaluate for cholecystitis History: Abdominal pain, nausea, vomiting. Also history of pancreatitis. LIVER: The liver measures 12.9 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.27 m/s.BILIARY TRACT: Cholelithiasis without associated gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: Within the proximal pancreatic body, there is a well-defined hypoechoic mass measuring 3.4 x 3.0 x 3.5 cm which appears solid but lacks visible internal vascularity. The more distal pancreas is obscured by bowel gas. The more proximal pancreatic duct does not appear dilated.SPLEEN: No significant abnormalities noted. The spleen measures 9.2 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted.
1.Cholelithiasis without sonographic evidence of acute cholecystitis.2.Pancreatic lesion measuring up to 3.5 cm which is incompletely characterized. Differential considerations include pancreatic cancer or pseudocyst. MRCP is recommended for additional evaluation.3.Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration.Discussed with Dr. JACOBS, JEFFREY. 