Indication: Right upper quadrant pain, elevated liver function tests
Sonographic Murphy sign: Negative
Hepatomegaly with diffusely increased echogenicity of the hepatic parenchyma, suggestive of steatosis, which limits assessment of the intrahepatic veins and bile ducts. Reversal of flow in the main portal vein likely relates 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.