<p>The kidneys are normal in size, shape, and outline. They measure 86mm and 90mm in their respective bipolar lengths on the right and left sides. They show loss of corticomedullary distinction and increased in their parenchymal echogenicity greater than liver and spleen on the right and left sides. No pelvicalyceal system dilatation or calculus is seen.</p><p>The liver is normal in size with uniform parenchymal echo pattern. No focal hepatic mass lesion is seen. The gall bladder is demonstrated with good mucosal wall coating, no stone or sludge seen within it. The intra-hepatic biliary system and the common bile duct are within normal limits.&nbsp;</p><p>The pancreas and the para aortic regions are within normal limits.</p><p>&nbsp;The spleen is normal in size and parenchyma echo pattern.</p><p>Mild complex, intra abdominal fluid collection with dense internal echoes and thick septations, is noted in the right hypochondriac and iliac region.</p><p>The visualized bowel loops show moderate mucosal wall thickening. They are however normal in calibre and outline.</p><p>The urinary bladder is modertely distended with urine containing low level echoes due to cystitis. No calculus is seen.</p><p><strong>&nbsp;</strong></p><p><strong>Conclusion</strong>:&nbsp;</p><p>1. Bilateral grade III renal parenchymal disease</p><p>2. Intra abdominal complex fluid collection ?bowel perforation</p>