Normal upper abdominal ultrasound

Case contributed by Dennis Odhiambo Agolah


Right flank to iliac fossa pain and vomiting.

Patient Data

Age: 13 years
Gender: Female

The liver is orthotopic, normal in size (10.06 cm measured in the midclavicular line), shape and echopattern. No intra/ extrahepatic parenchymal focal lesions. The hepatic vessels and the biliary radicles are not dilated. The acalculous gallbladder is normal in distension (5.81 x 1.47 cm) with no evidence of wall thickening or peripheral pathology. The sonographic Murphy's sign is negative. IVC, abdominal aorta and the main portal vein are normal (with the MPV showing normal hepato-petal/antegrade flow).

The pancreas (2.07 x 1.22 x 1.08 cm: AP measurement of head, body and tail) and the spleen (8.43 x 2.77 cm) are normal in echostructure and position. No visceral node enlargement, abdominal/ iliac fossa masses or ascites. The appendix is normal and measures 0.27 cm in diameter with no inflammatory changes or appendicolith.

Both kidneys are well perfused and are normal in their sizes (8.87 x 3.15 cm for the right and 7.03 x 2.99 cm for the left), and shapes with good cortical-medullary differentiation bilaterally and normal cortical thickness. No evidence of renal calculi, hydronephrosis or renal masses/ cysts bilaterally. The urinary bladder and the pelvic floor are normal.

Case Discussion

Essentially normal upper abdominal ultrasound scan examination. For reference. 

Measurements, shapes, sizes, positions, diameters/luminal distensions, parenchymal echotexture and vascular studies of the structures are documented. Bowel loops including the appendix (if still in situ) and the mesentery are evaluated as well with a linear sector array transducer.

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