Which of the following pathologies is most consistent with these sonographic findings?

The correct answer, biliary obstruction, aligns with specific sonographic findings typically associated with this condition. In cases of biliary obstruction, ultrasound can reveal key indicators such as dilated bile ducts and an abnormal appearance of the gallbladder. Depending on the cause of the obstruction, the visual evidence may include thickened walls of the biliary structures due to inflammation or other pathophysiological changes.

Biliary obstruction can result from factors such as gallstones, strictures, or tumors compressing the bile ducts, leading ultrasound to reflect these changes through distinctive patterns. This allows sonographers to identify obstructions and assess the extent of bile accumulation.

In contrast, while conditions like Caroli's disease and polycystic disease may present with cystic changes in the liver or kidneys respectively, they typically do not cause the same degree of duct dilation or inflammation seen in biliary obstruction. Similarly, portal hypertension can cause an increase in portal venous pressure and lead to a range of vascular sonographic findings but does not directly correlate with the dilated bile ducts, thus making biliary obstruction the condition that best matches the described sonographic features.