ปรึกษาปัญหาสุขภาพ

[Bmsd19]

รบกวนปรึกษาผลอัลตร้าซาวด์ของคุณพ่อค่ะ นิ่วที่เจอในถุงน้ำดีมีอัตรายไหมคะ แล้วต้องรักษาด้วยการผ่าตัดหรือไม่คะ/ขอบคุณค่ะ

Gender: M

HISTORY: A case presented with fever and abnormal LFT. To work up liver abscess or cholangitis. ULTRASONOGRAPHIC STUDY OF UPPER ABDOMEN: COMPARISON: No previous study to compare. FINDINGS: The liver shows normal size, shape and parenchymal echogenicity. No obvious space-occupying lesion in liver is detected. No dilatation of intrahepatic bile duct or common bile duct is seen. The CBD is measured about 0.4 cm. The gallbladder is distended containing a few gallstones, size up to 0.9 cm. Diffuse gallbladder wall thickening is observed, measured about 0.6 cm. No pericholecystic fluid is seen. Sonographic Murphy’s sign is negative. The visualized spleen and pancreas appear unremarkable. Both kidneys are of normal size with increased echogenicity. Right and left kidneys are measured about 10.5×4.6×4.9 cm and 9.7×5.0x4.9 cm, respectively. Diffuse increased echogencity of renal medulla of both kidneys is seen. There are a few simple cysts in both kidneys, size about 0.6-0.8 cm. No obvious solid renal mass, perinephric collection or hydronephrosis is seen. No gross ascites is observed. IMPRESSION: – No demonstrable space-taking lesion in the liver. – Distended gallbladder with diffuse gallbladder wall thickening and a few gallstones but negative sonographic Murphy’s sign. : DDx early acute cholecystitis or due to systemic process. Please correlate with clinical context. – Bilateral renal parenchymal disease. Diffuse increased echogencity of renal medulla, probably medullary nephrocalcinosis.- A few simple cysts in both kidneys, size about 0.6-0.8 cm.

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