A patient presents with an occasional history of right upper quadrant pain following a spicy meal. The sonographic findings are most consistent with which of the following abnormalities?

The correct answer is cholelithiasis, which refers to the presence of gallstones in the gallbladder. The patient's symptoms of right upper quadrant pain, especially following the consumption of spicy meals, are classic indicators of gallbladder-related issues. Gallstones can obstruct the normal flow of bile and trigger pain after certain meals, particularly those that are rich in fat or spice.

Sonographically, cholelithiasis is typically identified by the presence of echogenic structures within the gallbladder that create acoustic shadowing, indicating the presence of stones. This non-invasive imaging technique allows for direct visualization of gallstones, confirming the diagnosis.

In contrast, conditions like cholangitis, which involves inflammation of the bile ducts often due to infection, would typically present with additional symptoms such as fever and jaundice, and sonographic findings may show biliary ductal dilatation. Cholecystitis is characterized by inflammation of the gallbladder, usually due to obstruction caused by gallstones, but often presents with more severe pain and possible wall thickening seen on ultrasound. Cholesterolosis is a condition where cholesterol accumulates within the gallbladder wall, typically asymptomatic and less commonly associated with pain directly following meals.

Focus on