History of renal failure on hemodialysis with mid epigastric/right upper quadrant pain. Rule out pancreatitis/cholecystitis. LIVER: The liver measures 15.4 cm in length. There is coarse increased echogenicity. The portal vein is patent with hepatopetal flow measuring 25.1 cm/s. A moderate amount of ascites is present. No worrisome masses are seen. There is no intrahepatic ductal dilation.BILIARY TRACT: The gallbladder is contracted. The gallbladder wall measures 0.4 cm. No stones, sludge, or signs of acute inflammation are seen. Negative sonographic Murphy sign. The common bile duct measures 0.5 cm.PANCREAS: The pancreas is not well-visualized due to bowel gas.SPLEEN: The spleen measures 8.4 cm in length. No significant abnormalities are noted.RIGHT KIDNEY: The right kidney is difficult to visualize, it measures 6.8 cm in length. It has significantly increased echogenicity. LEFT KIDNEY: The left kidney was unable to be visualized on this study as patient was unable to lie flat.
1. The gallbladder is contracted without stones, sludge, or signs of acute inflammation.2. There is coarse increased echogenicity within the liver compatible with fatty liver/parenchymal dysfunction. A moderate amount of ascites is present. 3 The pancreas is not well-visualized due to bowel gas.4. The right kidney has increased echogenicity compatible with known medical renal disease. The left kidney was unable to be visualized as patient was unable to lie flat.