Epigastric pain presenting through A&E.
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The liver appears slightly hypoechoic, and enlarged measures 20 cm in length.
Amorphous appearance of the gallbladder depicting markedly thickened wall with pericholecystic edema. No stones are seen.
The CBD is normal in caliber measures 3 mm. No intrahepatic biliary ductal dilatation.
The spleen is enlarged measures 14.5 cm.
The portal vein is patent.
The pancreas and both kidneys are normal and no ascites is seen.
A 30-year-old lady presenting though the emergency room with epigastric pain, dark urine, pale stool, and labs showed elevated bilirubin levels. Abdomen ultrasound was requested demonstrating diffusely enlarged hypoechoic liver, with thickened gallbladder wall, pericholecystic fluid and mild splenomegaly. Although non-specific, findings are suggestive of acute hepatitis. Laboratory assessment is recommended for confirmation.