The gallbladder is distended and oedematous with surrounding hyperaemia (wall thickness 0.4 cm). Mobile calculi and sludge are present within its lumen.
Small volume free fluid in the right upper quadrant.
The common bile duct is dilated to 0.8 cm with low-level internal echoes seen throughout its lumen to the level of the ampulla. No CBD stone identified anywhere along its course. There is intra-hepatic duct dilatation as seen on the recent CT. The pancreatic duct is not dilated.
The main portal vein is patent and demonstrates normal directional blood flow.
Conclusion:
1. Features in keeping with acute calculus cholecystitis.
2. Dilatation of the intra and extrahepatic ducts as seen on CT. The CBD was well visualised with sludge seen throughout its lumen. No evidence of a CBD stone.