Abdominal ultrasound is an examination that allows you to assess the condition of the abdominal organs and detect even minor abnormalities and changes in their structure. What are the indications for an abdominal ultrasound? How should you prepare for the test? How is the test carried out?

ultrasound of the abdominal cavityshould include:

  • liver with an assessment of the gallbladder, intra- and extrahepatic bile ducts and liver vessels
  • pancreas
  • spleen
  • adrenal glands
  • kidneys with derivation
  • bladder
  • large abdominal vessels (aorta, inferior vena cava and iliac vessels - however, this assessment is not equivalent to Doppler assessment) with retroperitoneal structures
  • pelvic organs - uterus and ovaries in women and prostate in men

In the case of the latter, endocavital tests are the reference ones, which consist of an ultrasound probe inserted through the natural orifices of the body (vagina, anus), which are the domain of gynecologists and urologists, respectively. Transabdominal examination is often a preliminary examination for endocavital examinations or often a complementary examination, e.g. in women with lower abdominal pain in order to exclude other conditions not directly related to the reproductive organ, such as acute appendicitis, diverticulitis or the presence of a hernia, etc.

In addition to the basic ultrasound examination of the abdominal cavity, there are detailed examinations - Doppler examinations of the abdominal arteries and examinations using a different type of transducers - microconvex for the aforementioned endocavital examinations, proctological transducers or transesophageal ultrasound transducers.

ultrasound of the abdominal cavity - indications

The indications for ultrasound examination of the abdominal cavity should be those for which urgent examinations are performed, i.e. without prior preparation:

  • patients with pain symptoms from the abdominal cavity, especially patients with symptoms of the so-called acute abdomen (e.g. in suspected acute pancreatitis, in suspected gastrointestinal perforation, in diagnosed upper or lower gastrointestinal bleeding, in suspected acute appendicitis, in patients withwith symptoms of renal colic, suspected dissection or rupture of the abdominal aortic aneurysm and in other acute conditions of the abdominal cavity)
  • trauma patients
  • in the diagnosis of jaundice, fever of unknown origin, etc.

There are no contraindications for the ultrasound examination of the abdominal cavity. Due to the safety for the tested person, it is possible to repeat the tests, e.g. when monitoring the progress of treatment.

Urgent examinations are often very valuable in the course of a quick diagnosis of acute conditions, but you need to be aware of their limited value due to the fact that the patient is not prepared for the examination.

Ultrasound examination of the abdominal cavity is performed as planned to assess the condition of the abdominal organs in asymptomatic and symptomatic patients, or in the treatment of chronic diseases, e.g.

  • diabetes
  • hypertension
  • prolonged vomiting and / or diarrhea
  • weight loss
  • stopping or difficulty passing urine and / or stool
  • abdominal enlargement for no apparent reason
  • palpable tumor of the abdominal cavity, etc.

Read also: Mobile ultrasound - how does this modern version of ultrasound work?

Worth knowing

Scheduled examinations (abdominal cavity, Doppler vascular examination) are performed after prior preparation. Preparing the patient for the examination has a very significant impact on its quality - the doctor performing the ultrasound is able to see much more when the patient is properly prepared. In the absence of preparation, large amounts of intestinal gas can be expected, obscuring the visibility of internal organs. Often you get a description such as "test with limited diagnostic value, the pancreas invisible, obscured by gases, it is recommended to re-test after preparation".

Ultrasound of the abdominal cavity - how to prepare for the examination?

The patient should report for the examination on an empty stomach (i.e. without eating or drinking any fluids before the examination), in the morning. If the test is in the afternoon, it is advisable to refrain from food and drink for 6-8 hours prior to the test. You should also not smoke cigarettes, chew gum or, for example, candy on the day of the examination. If possible, it is advisable to regulate your bowel movements in advance.

You can also improve the quality of the test by introducing2 days before the test, an appropriate diet- i.e. without bloating foods: e.g. cabbage, peas, beans, apples, grapes and other stone fruits, or carbonated drinks. Additionally, degassing agents can be used, e.g.Espumisan, 3 days before the test day (2 tablets 3 times a day), however, do not take any tablets on the test day.

ultrasound of the abdominal cavity - the course of the examination

Ultrasound examination of the abdominal cavity should typically start a physical examination, i.e. an interview with the patient, which can be continued smoothly during the main part of the examination. An important point is also the information whether the ultrasound examination of the abdominal cavity has been performed before. If so, for what reason (is it the same as now, or another - what?) And are the results of previous studies available to compare the dynamics of changes.

The test is typically performed in the supine position with the arms placed freely along the side edges of the couch or on the chest to allow easy access to the side areas. During the test, the patient may be asked to draw in a large amount of air ("into the abdomen") and hold it for as long as possible. This is to move some organs in order to better visualize them, temporarily immobilize them and thus improve the examination conditions.

There is no clearly defined sequence in which organs are examined. It is adjusted to the patient's current condition and modified in relation to the reported symptoms. During the examination, the patient may be asked to change the position of the right side, left side, and sometimes the abdomen. In some situations, the test may be continued in a standing position.

The research should end with a description with conclusions either marked in the text or at its end.

Read also: Transrectal ultrasound - indications and preparation for the examination

ultrasound of the abdominal cavity - test results

The obtained images should be interpreted on the basis of the physical examination (interview), physical examination (palpation, sometimes deliberate pressure with the transducer is also performed).

In the case of control tests, it is important to assess the dynamics of changes based on the presented previous results with photos. The conclusions should include recommendations for further treatment - ultrasound checkup, verification in other CT / MRI imaging techniques or consultation with a family doctor or specialist.

Worth knowing

Abdominal ultrasound - is it safe?

Ultrasonography is one of the imaging techniques used to assess the condition of organs, vessels and joints in various parts of the body. Currently, there are few speci alties that would not use this imaging technique. There is a reason why ultrasound is sometimes referred to as "an extension of the doctor's hand."

It should be noted that when comparing it with classical imaging techniques, such as X-ray, tomographycomputer, magnetic resonance or radioisotope tests, it is safe for both the examined person and the person performing the examination. According to the current knowledge, no negative influence of ultrasound has been noted on the tissues under examination, compared, for example, to techniques using ionizing radiation.

Ultrasound of the abdominal cavity - how often to do? Who to refer to?

An ultrasound examination of the abdominal cavity may be ordered by a family doctor, as well as by a specialist doctor, depending on the indications.

When issuing a referral, the doctor will find valuable information on the surgeries performed (especially if on the day of the examination it is not possible to present discharge cards from the previous hospital treatment), chronic diseases, up-to-date results of laboratory or imaging tests (USG, CT , MR) - if they were the basis for the extension of diagnosis, burden in the family history of chronic diseases, neoplastic diseases, and all other clinically relevant information.

Prophylactic examination can be performed at intervals, e.g. every 3 or 1-2 years. People diagnosed with proliferative diseases after or during treatment may also have a follow-up ultrasound examination of the abdominal cavity at time intervals according to the established protocol.

Read also: What is an ultrasound examination and where to do it?

Worth knowing

Ultrasound of the abdominal cavity - advantages and disadvantages

The undoubted advantage of the study is its safety for both the examined and the researcher. Another advantage is the possibility of conducting a subjective examination before and / or during the examination, as well as the possibility of selecting any number of sections and the possibility of using other standard options that are in the apparatus, depending on the current need.

What are the disadvantages of liver ultrasound?Its accuracy depends on the experience of the operator, the quality of the apparatus itself, and the examination conditions. The translucency of the abdominal soft tissues has a significant impact on the accuracy of the examination. Obese people, as a rule, but not always, are worse tested than lean people. Swelling of the soft tissues, which is not synonymous with obesity, affects the visibility of organs in the abdominal cavity to a greater or lesser extent and limits the examination, e.g. in renal failure, heart failure and other systemic diseases.

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