Demographics:
46 years old, Female
Indication:
Right upper quadrant pain, elevated liver function test...
Right upper quadrant pain, elevated liver function tests, negative sonographic Murphy sign
Findings
- Edematous and thickened gallbladder wall
- Gallbladder is nondistended with no gallstones identified
- Liver is enlarged measuring 21.6 cm in craniocaudal span with possible mildly nodular surface contour
- Diffusely increased echogenicity of the hepatic parenchyma, which markedly limits assessment of the intrahepatic portal and hepatic veins and intrahepatic bile ducts
- Apparent bidirectional flow in the main portal vein
- Normal appearance of the spleen, kidneys, and urinary bladder
- Visualized portion of the pancreas appears normal
- Visualized portions of the abdominal aorta are normal in caliber
Diagnosis
Hepatitis
Sample Report
Hepatomegaly with diffusely increased echogenicity of the hepatic parenchyma, suggestive of steatosis, which limits assessment of the intrahepatic veins and bile ducts. Apparent bidirectional flow in the main portal vein may be artifactual, but if real could relate to intrinsic liver disease. Despite this, the spleen appears normal in size and no ascites is identified.
Edematous and thickened gallbladder wall without distension or gallstones, favored to relate to adjacent liver disease.
Query mildly nodular hepatic surface contour, concerning for cirrhotic change.
Discussion