The gallbladder is filled with heterogeneous avascular contents likely representing biliary sludge. It also contained several mobile gallstones. The gallbladder wall is thickened. No pericholecystic fluid. Sonographic Murphy sign was negative (although the patient had generalised upper abdominal tenderness). No biliary duct dilatation (maximal CBD diameter 5.8mm).
The liver parenchyma is homogeneous in echotexture. No focal liver lesion identified.
The pancreas has a normal appearance.
The spleen measures 8.1cm.
The right and left kidneys measure 12.2cm and 11.9cm respectively. The left kidney contains three simple cysts.
Conclusion: Findings are suspicious for acute cholecystitis.