Newly elevated bilirubin and INR, evaluate for choledocholithiasis LIVER: Diffuse coarse echotexture of the liver is noted, which approximately measures 23.5 cm. Enlarged liver. No evidence of intrahepatic biliary ductal dilatation.BILIARY TRACT: Gallbladder wall thickened. Cannot assess Murphy's sign as patient is intubated. Common hepatic duct appears mildly dilated measuring up to 1 cm without definite evidence evidence of stones. No evidence of gallstones.OTHER: Mild ascites.
Coarse echotexture of the liver, enlarged liver, suspicious for parenchymal dysfunction.Thickened wall of the gallbladder secondary to adjacent ascites, CBD is mildly dilated without definite evidence of stones. If clinically warranted, MRCP can be performed for further evaluation.