32-year-old female patient with septic shock, firm abdomen, acute kidney injury. Assess right upper quadrant, liver, gallbladder. LIVER:The liver measures 24.7 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/s.GALLBLADDER, BILIARY TRACT: There is sludge within the gallbladder, but no gallbladder wall thickening or pericholecystic fluid. No intra or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The visualized proximal pancreas is normal in echogenicity. The remaining pancreas is obscured by overlying bowel gas.SPLEEN: The spleen is not visualized.KIDNEYS: The right kidney measures 10.3 cm and the left kidney measures 7.6 cm in length. Renal cortical echogenicity is increased. No evidence of hydronephrosis.ABDOMINAL AORTA: The proximal and mid-abdominal aorta are normal in caliber. The distal abdomina aorta is obscured by overlying bowel gas.INFERIOR VENA CAVA: The IVC is patent. OTHER: The bladder is decompressed with a Foley catheter.
1. Hepatomegaly.2. Biliary sludge. 3. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction. No hydronephrosis.