Indication: Right upper quadrant pain
Sonographic Murphy sign: Negative
Intrahepatic and extrahepatic biliary duct dilation with nonvisualization of the distal common bile duct. Findings raise concern for a distal biliary obstruction, possibly relating to a gallstone or neoplasm. Recommend MRCP or ERCP for further assessment.
Multiple irregular hypoattenuating lesions in the left hepatic lobe measuring up to 3 cm, concerning for abscesses.
Distended gallbladder with wall thickening and layering sludge. Despite a negative sonographic Murphy sign, these findings could relate to cholecystitis. Alternatively, a common bile duct stone/obstruction or a cystic duct stone obstructing the common hepatic duct (Mirizzi syndrome) could be the etiology for these findings. Again, MRCP or ERCP could further evaluate.