63-year-old male with history of gastric cancer with recent biliary drain placement, abdominal pain with concern for cholecystitis on CT. LIVER: Mild increased echogenicity of the liver measuring 20.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is gallbladder wall thickening measuring 8 mm in thickness. No stones are visualized within the gallbladder. No pericholecystic fluid. Sonographic Murphy's sign is negative. A drain is noted within the biliary tract limiting evaluation for common bile duct caliber, however there is no intrahepatic biliary duct dilatation. PANCREAS: Obscured by overlying bowel gas.RIGHT KIDNEY: Measures 12.0 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.6 cm in length and is normal in echogenicity. There is mild pelvicaliceal dilatation of the inferior pole. No shadowing calculi are noted.Normal echogenicity of the spleen measuring 10.3 cm in length.
1. Gallbladder wall thickening is noted with no evidence of cholelithiasis. Given that these findings are new based on prior CT scans, this is suspicious for acute acalculous cholecystitis.2. Mild increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. 3. Mild left sided pelvicaliceal dilatation. 