Ultrasound Upper Abdomen

An upper abdominal ultrasound visualizes the liver, gallbladder, bile ducts, pancreas, spleen, upper kidneys and abdominal aorta. It detects gallstones, bile duct obstruction, liver enlargement, fatty change, masses or cysts, pancreatitis, splenic abnormalities, kidney lesions and free fluid. It assesses organ size, texture and blood flow (with Doppler) to help diagnose inflammation, infection, tumors or vascular problems.

For an upper abdominal ultrasound, fast six to eight hours beforehand (no food, milk or fatty drinks) to keep the gallbladder full and reduce bowel gas. Take essential medications with small sips of water. Avoid smoking and chewing gum. Wear loose, comfortable clothing and bring referral paperwork or previous imaging. Follow any extra instructions from your clinic.

The “best” scan depends on the suspected problem. For gallbladder/biliary disease and initial liver assessment, abdominal ultrasound is first-line. For comprehensive evaluation of upper abdominal organs, trauma, infection, or suspected cancer, contrast-enhanced CT is preferred. MRI with MRCP is best for bile-duct and liver lesion characterization; endoscopic ultrasound is most sensitive for small pancreatic lesions.

An abdominal ultrasound can detect liver cancers (primary hepatocellular carcinoma and liver metastases), kidney tumours, gallbladder and biliary tract cancers when masses or bile-duct dilation are present, some pancreatic and splenic lesions, large ovarian or pelvic masses, and enlarged retroperitoneal lymph nodes or masses (e.g., lymphoma). It’s a useful screening tool but has limits—CT/MRI and biopsy are often needed for definitive diagnosis.

Ultrasound cannot reliably detect most peptic (gastric or duodenal) ulcers. Endoscopy is the gold standard for direct visualization and biopsy. Ultrasound may suggest complications—free fluid, localized inflammation or perforation signs, or wall thickening—but it’s less sensitive than CT for perforation and not diagnostic for ulcers themselves. If an ulcer is suspected, see a clinician for endoscopy or CT as needed.

Endoscopy is usually not painful. Upper endoscopy may cause throat scratchiness, gagging or mild discomfort; sedation or local anesthesia reduces pain. Colonoscopy often uses sedation and can cause pressure, cramping or bloating during and after the procedure. Most discomfort is short‑lived; serious pain, heavy bleeding or fever are rare—seek urgent medical attention if these occur.