Septic shock. Elevated alkaline phosphatase. LIVER: Non-cirrhotic liver morphology. Innumerable metastatic lesions are again noted. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Status post cholecystectomy.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: Status post right nephrectomy. The left kidney is 12.8 cm in length with simple appearing cysts, measuring up to 3.3 cm.. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 11 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. Bilateral pleural effusions. Small amount of ascites identified.
1. No specific findings to account for the patient's septic shock. 2. Small amount of ascites and bilateral pleural effusions.