81-year-old male with leukocytosis, conjugated hyperbilirubinemia LIVER: Increased hepatic echogenicity without discrete focal lesionGALLBLADDER, BILIARY TRACT: Redemonstration of cholelithiasis and biliary sludge, now with mild gallbladder distension. Mild gallbladder wall thickening, but no pericholecystic fluid or sonographic Murphy sign. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.KIDNEY: Not included on this examination. OTHER: No significant abnormalities noted.
The abnormal appearance of the gallbladder as described above remains nonspecific, but given the persistence of symptoms and sonographic findings, both acute and chronic cholecystitis are differential considerations. If further imaging evaluation is warranted, a nuclear medicine hepatobiliary scan may be considered. 