Abdominal ultrasound

Which organs may be examined

The examination may include the liver, the gallbladder and bile ducts, the kidneys, the spleen, the pancreas and the abdominal aorta. How well each structure can be seen varies with anatomy, preparation and bowel gas. For some questions Doppler may be used, which gives information about blood flow.

In the liver, changes suggesting hepatic steatosis, that is, fatty liver, cysts or other lesions may be seen. In the urinary system, visible stones, dilation of the urine collecting system or changes in size may be assessed. The structural image alone does not show how well an organ works: the kidneys are also assessed with blood and urine tests.

When it is particularly useful

When gallstones are suspected, ultrasound and the relevant tests are often the first steps. The doctor looks for stones, changes in the gallbladder wall or dilation of the bile ducts. Stones found by chance do not automatically explain every digestive complaint; the pattern of pain and the accompanying signs matter.

Ultrasound may also help when liver tests remain abnormal or when obstruction of urine flow is suspected. It does not always identify the final cause. A finding may call for comparison with older examinations, further tests or other selected imaging.

How to prepare

Instructions depend on the organs to be assessed. For the upper abdomen you may be asked not to eat for several hours, while assessing the urinary bladder may require it to be full. Follow the instruction given at booking; there is no single preparation for every ultrasound.

Say if you have diabetes, a fluid restriction or difficulty going without food. Do not stop medicines and do not change insulin yourself in order to have the examination. Bring tests, previous reports and information about operations, since these affect interpretation.

What happens during the examination

The doctor applies gel to the skin and moves the probe over the abdomen. You may be asked to change position or to hold your breath for a few moments. Pressure over a tender area may cause discomfort; say if it hurts. A routine ultrasound needs no injection and does not usually prevent you from continuing daily activity.

The report should describe the organs assessed, the significant findings and the technical limitations. The statement that an organ was not well visualized does not mean it is normal. It means the question about that organ may remain open.

What a normal result does not exclude

Gas and the depth of organs may limit the examination. Ultrasound does not replace gastroscopy or colonoscopy for assessing the lining of the stomach and bowel. Not every urinary stone, small lesion or cause of abdominal pain is visible.

Even visible steatosis does not by itself show whether there is inflammation or how much fibrosis, that is, scar tissue, has formed in the liver. These questions need separate assessment. If symptoms persist despite a normal ultrasound, the doctor should review the diagnosis and the need for other investigation.

Frequently asked questions

Do I need to fast for an abdominal ultrasound? For the upper abdominal organs, such as the liver, gallbladder and pancreas, you are usually asked not to eat for several hours, because food contracts the gallbladder and increases gas. To assess the urinary bladder it needs to be full. Follow the instruction given at booking and ask if you have diabetes or take medicines.

Is ultrasound safe, even in pregnancy? Ultrasound uses no ionizing radiation and is considered safe, including during pregnancy, when performed for an indication. It can be repeated when there is clinical need. The usual technique needs no injection and has no effects that interfere with the rest of your day.

Why does the report say an organ “is not well visualized”? Bowel gas, a large body habitus or the position of the organ may limit the image. This does not mean the organ is normal, but that the question about it may remain open. The doctor may suggest repeating with better preparation or another examination.

Can ultrasound detect stomach or bowel cancer? Not reliably. Ultrasound does not assess the lining of the stomach and bowel; gastroscopy and colonoscopy are used for that. It may show some changes in the other organs of the abdomen, but a normal result does not exclude diseases of the digestive tube.

What does “fatty liver” in the report mean? It means hepatic steatosis: an accumulation of fat in liver cells, which makes the organ appear brighter on ultrasound. It is often linked to excess weight, diabetes or alcohol. Ultrasound alone does not show whether there is inflammation or fibrosis; the doctor clarifies this with tests and other assessments.

How often should abdominal ultrasound be repeated? There is no single interval for everyone. It is repeated when there are new symptoms, when a known finding is being followed or when the doctor has a defined question. Repeating it every year without a reason does not increase safety and may bring findings of no clinical importance.

When urgent care is needed

Care at Tirana Polyclinic: We perform abdominal ultrasound and link the result to the consultation and the relevant tests. When other examinations are needed, we give guidance and specialist interpretation of imaging materials performed at other centers.