Hello, I hope you´re well. According to the symptoms and the findings in the image study that you present may be related to gallbladder lithiasis. The presence of gallstones is common. Incidental gallstones are gallstones that are diagnosed in an asymptomatic patient based on an imaging study that was obtained for an unrelated reason. There are several types of gallstones; they are composed of a mixture of cholesterol, calcium bilirubinate, proteins, and mucin. The most frequent are those of cholesterol in up to 75%, and the diagnostic study of choice is through an abdominal ultrasound. The majority of patients found to have incidental gallstones will remain asymptomatic. Patients who develop symptoms typically report biliary colic. It is rare for a previously asymptomatic patient to present with complications of gallstone disease without first having had episodes of biliary colic. The recommend following for most patients with incidental gallstones expectantly rather than performing prophylactic cholecystectomy. Waiting until a patient becomes symptomatic before performing cholecystectomy prevents unnecessary surgery since the majority of patients with incidental gallstones will never develop biliary colic. However, prophylactic cholecystectomy is indicated for patients who are at increased risk for gallbladder cancer and are good surgical candidates. You should know that the symptomatic gallstones are uncommonly treated with medical therapy alone. The main form of medical therapy is the bile acid ursodeoxycholic acid, which may enhance gallstone dissolution and perhaps reduce symptoms in patients with mild symptoms or those who are not candidates for laparoscopic surgery. The dissolution therapy with ursodeoxycholic acid is indicated in patients with mild symptoms who have poorly calcified small stone(s) and are not candidates for laparoscopic cholecystectomy.