Male 77 years old with elevated bili, fever/septic shock, assess for cholangitis LIMITED ABDOMENLIVER: The liver has a smooth contour, it measures 22.0 cm in length. The parenchyma is mildly coarse and echogenic . No focal liver lesion is identified. The main portal vein is patent and demonstrates hepatopetal flow with a velocity of 3.0 m/s. There is a small amount of perihepatic ascites.BILIARY TRACT: There is no cholelithiasis. The gallbladder wall is thickened at 1.2 cm, there is no pericholecystic fluid. Common duct measures 4 mm in diameter, there is mild thickening of the common bile duct wall. There is no intrahepatic biliary ductal dilatation or focal liver lesion.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 13.2 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 12.7 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 11.9 cm. in length. There are scattered splenic calcifications.OTHER: Trace right pleural effusion.
1.Gallbladder wall edema and mild thickening of the common duct wall are non-specific findings that can be seen in cholangitis. 2.Hepatomegaly with mildly echogenic liver parenchyma compatible with hepatic steatosis/parenchymal dysfunction.