Preop for LVAD LIVER:Liver measures 15.5 cm with diffuse coarse echotexture. No focal lesions noted within the liver. No intrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Gallbladder is well distended with multiple gallstones within it. Gallbladder wall appears slightly thickened, reaching upper limit of normal up to 3 mm. Minimal fluid noted in the pericholecystic space. Common hepatic duct measures up to 3 mm.Negative sonographic Murphy signPANCREAS: Head and body of pancreas visualized appears unremarkable. Tail of pancreas not visualized due to overlying bowel gas.SPLEEN: Spleen measures 10.3 cm, normal echotexture.KIDNEYS: Right kidney measures 9 cm and left kidney measures 9.4 cm. Simple cyst identified in both kidneys, largest cyst in the right kidney measures 2.7 x 2.4 x 1.7 cm. No hydronephrosis. ABDOMINAL AORTA: Proximal aorta measures 1.7 x 2.2 x 1.3 cm. No evidence of aneurysmal dilatation or atherosclerotic changes. Mid aorta measures 1.6 x 2 x 1.6 cm and distal aorta measures 1.4 x 1.6 x 1.5 cm. The proximal right and left iliac arteries also demonstrate normal caliber.INFERIOR VENA CAVA: PatentOTHER: Mild right pleural effusion.
Distended gallbladder with gallstones and mild gallbladder wall thickening reaching upper limit of normal and minimal pericholecystic fluid. Findings are equivocal for acute cholecystitis however if clinically suspicious, HIDA scan can be performed for further evaluation.Mild right pleural effusion.Bilateral simple renal cysts.Findings conveyed to pager 1467, Dr. Lauren feld at the time of dictation 1:18 p.m, 4/28/16.