Reason: acute pancreatitis, evaluate for gallstones LIVER: The liver measures 14 cm in length. There are multiple well-defined, round hypoechoic-to-isoechoic solid hepatic lesions. Two representative lesions in the right lobe measure 4.5 x 3.9 x 4.6 cm and 3.8 x 3.4 x 2.8 cm. The portal vein is patent with normal directional hepatopedal portal venous blood flow, peak velocity 28 cm/s.GALLBLADDER, BILIARY TRACT: Multiple shadowing gallstones in the dependent aspect of the gallbladder and gallbladder neck. No pericholecystic fluid or evidence of acute inflammation. The gallbladder wall measures 0.2 cm. The common bile duct measures 0.4 cm. No biliary ductal dilatation.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 11 cm in length. No hydronephrosis or stones.LEFT KIDNEY: The left kidney measures 11.2 cm in length. No hydronephrosis or stones.OTHER: Left pleural effusion.
1. Multiple solid hepatic lesions as described above, suspicious for metastases. MRI of the liver is recommended for further evaluation.2. Cholelithiasis without evidence of acute inflammation.