57 years old, Male, Reason: 57 male with lung cancer, known liver mets. Worsening RUQ pain, transaminitis. Assess status of liver mets, evaluate for biliary disease History: RUQ pain, transaminitis LIVER: The liver is enlarged measuring 26.7 cm in length. The hepatic parenchyma is extremely heterogeneous consistent with metastatic disease appearing similar to prior exam. The main portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is contracted and not well visualized. No intrahepatic or extrahepatic biliary ductal dilatation is present, the common bile duct measures 4.5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length, no hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length, no hydronephrosis.OTHER: No evidence of ascites.
1.Suboptimal assessment of gallbladder secondary to contracted state. 2.Hepatomegaly with extremely heterogeneous hepatic parenchyma, consistent with known metastatic disease.