<p>The liver is normal in size and parenchymal echogenicity. No focal hepatic mass lesion is seen. The intrahepatic biliary channels and CBD are not dilated.&nbsp;</p><p>The gallbladder is moderately distended with bile and clear contents and mucosal wall thickness. No calculus is seen within it.&nbsp;</p><p>The kidneys are normal in their positions, shapes, sizes, outlines and parenchymal echogenicity. They show prominence of their medullary pyramids with preserved corticomedullary differentiation. &nbsp;No definite focal renal mass lesion or hydronephrosis is seen.</p><p>The spleen, pancreatic bed, paraaortic area and the urinary bladder are within normal limits.</p><p>The visualized bowel loops shows normal caliber, outline and peristaltic activity. No bowel mass lesion is seen.&nbsp;</p><p>Following high resolution ultrasound scan of the right iliac fossa using graded compression technique revealed a dilated on compressible aperistaltic blind ended tubular structure measuring 6.6mm in diameter in keeping with inflamed appendix. No peri-appendiceal fluid collection. However, there is probe tenderness over the right iliac fossa.&nbsp;</p><p>The urinary bladder is within normal limits.</p><p>The uterus is normal in size and empty. It measures 42mm in it is widest AP diameter. It shows uniform myometrial and endometrial echoes. It shows no definite focal myometrial or endometrial mass lesion seen.&nbsp;</p><p>Both adnexae are free. There is moderate fluid containing low level internal mobile echoes sis seen in the POD with mild supra-pubic tenderness.&nbsp;</p><p><strong>Conclusion :-&nbsp; 1. Sub acute appendicitis</strong></p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 2. Bilateral pyelonephritis&nbsp;</strong></p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 3. PID</strong></p><p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</strong></p><p>&nbsp;</p>