81-year-old female patient with right upper quadrant pain, fever, vomiting. Concern for choledocholithiasis. LIVER: The liver measures 15.1 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and contains gallstones. There is pericholecystic fluid. Marked bilobar intra- and extrahepatic biliary ductal dilatation is identified. The common duct measures 13 mm in diameter. No obstructing stone is identified on this examination, however, a stone is identified within the distal duct on the CTA from the same date.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 8.7 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.1 cm in length. No evidence of hydronephrosis.The spleen measures 7.5 cm in length.
1. Marked intra- and extrahepatic biliary ductal dilatation secondary to obstructing distal common bile duct as seen on CTA from the same date. 2. Cholelithiasis with distended gallbladder and pericholecystic fluid is likely secondary to obstructing distal CBD stone.