Reason: evaluate cholecystitis History: uptrending LFTs Exam is limited by inability to turn the patient.LIVER: Echogenic hepatic parenchyma, consistent with hepatic parenchymal dysfunction or steatosis.GALLBLADDER, BILIARY TRACT: The gallbladder is borderline distended. There is some evidence of edema around the gallbladder wall. There is a small volume of pericholecystic fluid. There is layering sludge within the dependent aspect of the gallbladder. An echogenic focus in the neck of the gallbladder with posterior acoustic shadowing may represent a stone, but the exam is limited due to the inability to turn the patient. The gallbladder wall measures 3 mm, normal-upper normal.. The common bile duct measures 0.5 cm, normal in size.PANCREAS: Obscured by bowel gas.OTHER: Moderate volume of ascites.
Borderline gallbladder wall thickening, some evidence of gallbladder wall edema, and probable stone in the neck of the gallbladder. These constellation of findings may be seen in acute cholecystitis, however are nonspecific in the setting of ascites and limitations of this exam.