Abdominal Ultrasound: What It Shows and Why It’s Requested

An abdominal ultrasound is one of the most commonly requested scans for symptoms or blood test changes involving the liver, gallbladder, kidneys, pancreas, spleen and other structures in the tummy. It is painless, does not use X-rays, and can often give useful information quickly.

You may be sent for an abdominal ultrasound because of abdominal pain, abnormal liver blood tests, suspected gallstones, bloating, kidney symptoms, a lump or swelling, unexplained weight loss, abnormal urine tests, or follow-up of something seen on another scan. Some people also have ultrasound as part of a private health check or after private blood tests.

Like all tests, ultrasound has strengths and limitations. It is very useful for many abdominal organs, but it cannot diagnose every cause of pain or bowel symptoms. Sometimes it gives clear answers. Sometimes it shows a finding that needs monitoring or another test. Sometimes it is normal, even though symptoms are real and still need follow-up.

This guide explains what an abdominal ultrasound is, what it can show, why it is requested, how to prepare, what happens during the scan, how results are reported, what common findings mean, and when further tests may be needed.

What is an abdominal ultrasound?

An abdominal ultrasound is a scan that uses high-frequency sound waves to create pictures of the inside of the abdomen. A handheld probe, called a transducer, is moved over the skin with gel. The probe sends sound waves into the body and receives echoes back, which are turned into images on a screen.

Ultrasound does not use ionising radiation. This makes it different from X-rays and CT scans. It is generally considered a safe imaging test and is widely used in hospitals, community diagnostic centres and private clinics.

The NHS explains that ultrasound scans use high-frequency sound waves to create images of the inside of the body and may be used to examine internal organs such as the liver, kidneys and other abdominal organs. NHS ultrasound scan guidance.

Which organs can an abdominal ultrasound look at?

A standard abdominal ultrasound may look at several organs, depending on the reason for the request and the protocol used by the scanning department.

It may assess:

• Liver: size, texture, fatty change, cysts, masses, scarring signs and bile duct changes.
• Gallbladder: gallstones, sludge, inflammation, polyps and wall thickening.
• Bile ducts: whether the ducts are widened, which can suggest blockage.
• Pancreas: some abnormalities, although it can be hard to see clearly because of bowel gas.
• Spleen: size, enlargement, some focal abnormalities.
• Kidneys: cysts, swelling, obstruction, stones in some cases, and size.
• Bladder: if included, especially when urinary symptoms are present.
• Abdominal aorta: widening or aneurysm in some scans.
• Free fluid: fluid in the abdomen, also called ascites.
• Some lumps or hernias: depending on location and scan request.

Ultrasound may be focused on one organ, such as a liver ultrasound, gallbladder ultrasound, renal ultrasound or aortic aneurysm scan. The exact scan you receive depends on the question your clinician wants answered.

Why might an abdominal ultrasound be requested?

Doctors request abdominal ultrasound when symptoms, examination findings or test results suggest a possible problem in the abdominal organs. It is often used as a first-line scan because it is safe, widely available and good at showing many structural changes.

Common reasons include:

• upper abdominal pain
• right upper abdominal pain after meals
• suspected gallstones
• abnormal liver function tests
• jaundice or yellowing of the skin or eyes
• unexplained nausea or vomiting
• unexplained weight loss
• persistent bloating or abdominal swelling
• kidney pain or suspected obstruction
• blood in the urine
• recurrent urinary infections in some situations
• checking cysts or known benign findings
• suspected enlarged liver or spleen
• screening or checking for abdominal aortic aneurysm in specific groups
• follow-up after abnormal blood tests or another scan

If you are having ultrasound because of pain or digestive symptoms, related guides include abdominal pain by location, bloating, digestive health symptoms and gastroscopy: when it’s needed and what it shows.

What symptoms can an abdominal ultrasound help investigate?

Abdominal ultrasound can help when symptoms point towards gallbladder, liver, kidney, spleen, aorta or fluid-related problems. It is less helpful for many bowel conditions, although it may still be used as part of a wider assessment.

Symptoms that may lead to ultrasound include:

• pain under the right ribs
• pain after fatty meals
• upper abdominal pain spreading to the back
• persistent nausea
• jaundice
• dark urine and pale stools
• abdominal swelling
• unexplained loss of appetite
• unexplained weight loss
• flank pain or kidney-area pain
• urinary symptoms with abnormal tests
• a pulsating abdominal mass

Symptoms such as blood in the stool, a persistent change in bowel habit or suspected bowel inflammation may need stool tests, blood tests, colonoscopy or CT rather than ultrasound alone. See blood in stool, colonoscopy preparation and procedure and IBD explained.

Abdominal ultrasound for gallstones

One of the most common reasons for abdominal ultrasound is suspected gallstones. Gallstones can cause pain in the upper right abdomen, especially after meals, and may be linked with nausea, vomiting or pain spreading to the back or right shoulder.

Ultrasound is very good at detecting gallstones in the gallbladder. It can also show gallbladder wall thickening, tenderness when the probe presses over the gallbladder, fluid around the gallbladder, or widening of bile ducts. These findings can help doctors decide whether there may be inflammation or blockage.

Ultrasound may show:

• gallstones
• gallbladder sludge
• gallbladder inflammation
• bile duct widening
• some gallbladder polyps

If gallstones are suspected, read our guide to gallstones, gallbladder pain and when surgery is needed.

Abdominal ultrasound for liver problems

Liver ultrasound is commonly requested after abnormal liver function tests, right upper abdominal discomfort, suspected fatty liver, jaundice, enlarged liver, alcohol-related concerns, viral hepatitis monitoring or follow-up of known liver conditions.

Ultrasound can show liver size, texture and some structural changes. It may identify fatty liver, cysts, some tumours, signs of cirrhosis, enlarged bile ducts or fluid in the abdomen. However, ultrasound cannot always tell exactly why liver blood tests are abnormal, and it cannot detect every early liver disease.

Possible liver findings include:

• fatty liver change
• liver cysts
• solid liver lesions that need further assessment
• cirrhosis features in some cases
• enlarged liver
• bile duct dilatation
• ascites, meaning fluid in the abdomen

If your scan was requested because of blood tests, see liver function test results explained and how to understand blood test results.

Abdominal ultrasound for kidney problems

Ultrasound can assess the kidneys and sometimes the bladder. It may be requested for flank pain, blood in the urine, abnormal kidney blood tests, recurrent urinary problems, suspected obstruction, kidney cysts or follow-up of known kidney findings.

A kidney ultrasound may show:

• kidney size
• kidney cysts
• swelling of the kidney drainage system, called hydronephrosis
• some kidney stones
• structural abnormalities
• bladder emptying problems if a bladder scan is included

Not all kidney stones are seen on ultrasound. CT is often more sensitive for stones, especially small stones in the ureter. If your symptoms strongly suggest a stone but ultrasound is normal, your doctor may still consider further tests.

Related guides include kidney blood test results explained, urine test results explained and pain when urinating.

Abdominal ultrasound for pancreatic problems

The pancreas sits deep in the upper abdomen, behind the stomach. Ultrasound can sometimes assess it, but it is often harder to see clearly because bowel gas can block the view.

Ultrasound may be requested if there is upper abdominal pain, abnormal liver tests suggesting bile duct blockage, jaundice, suspected pancreatitis or unexplained weight loss. It may show a dilated bile duct, gallstones or obvious pancreatic abnormalities, but a normal ultrasound does not always rule out pancreatic disease.

If the pancreas cannot be seen well or symptoms are concerning, CT, MRI or specialist tests may be needed.

Abdominal ultrasound for spleen enlargement

The spleen is an immune-related organ in the upper left abdomen. Ultrasound can measure spleen size and look for some abnormalities.

A spleen ultrasound may be requested if a doctor feels an enlarged spleen, blood tests are abnormal, infections are suspected, liver disease is being assessed, or there are unexplained symptoms such as weight loss, fever or swollen lymph nodes.

If swollen glands or blood test changes are part of the picture, related guides include swollen lymph nodes and full blood count results.

Abdominal ultrasound for abdominal aortic aneurysm

Ultrasound can measure the abdominal aorta, the main blood vessel running through the abdomen. A widening of this vessel is called an abdominal aortic aneurysm, or AAA.

In the UK, there is an NHS abdominal aortic aneurysm screening programme for men in the year they turn 65. Some people may also have an aortic ultrasound because of symptoms, family history, examination findings or incidental concerns.

AAA screening is different from a general abdominal ultrasound, although both use ultrasound technology. If your scan report mentions aortic size, your doctor will explain whether follow-up is needed.

What can an abdominal ultrasound not show well?

Ultrasound is useful, but it has limitations. Sound waves do not travel well through air or bone, and images can be affected by body shape, bowel gas, pain, movement, scarring and how well the organs can be reached with the probe.

Ultrasound may not show:

• many causes of bowel symptoms
• early bowel cancer
• small stomach or bowel ulcers
• many causes of indigestion or reflux
• small pancreatic lesions hidden by bowel gas
• some kidney stones
• very small liver or abdominal lesions
• functional conditions such as IBS
• microscopic inflammation

This is why your doctor may request other tests even after an ultrasound. For example, gastroscopy looks inside the oesophagus, stomach and duodenum. Colonoscopy looks inside the large bowel. CT and MRI can give different types of information.

Ultrasound versus CT, MRI, gastroscopy and colonoscopy

Different tests answer different questions. A normal ultrasound does not replace every other investigation.

• Ultrasound: good for gallstones, liver texture, kidney swelling, cysts, fluid and aorta size. No radiation.
• CT scan: better for many urgent abdominal problems, some cancers, bowel complications, stones and complex anatomy. Uses X-rays.
• MRI scan: useful for detailed liver, bile duct, pancreas and pelvic imaging in selected cases. No ionising radiation.
• Gastroscopy: looks directly inside the oesophagus, stomach and duodenum.
• Colonoscopy: looks directly inside the large bowel and can remove polyps or take biopsies.
• Blood and stool tests: can show inflammation, anaemia, infection, liver changes, kidney function or hidden blood.

If you are trying to understand where ultrasound fits alongside other tests, see how to understand scan results and how to understand medical test results.

How to prepare for an abdominal ultrasound

Preparation depends on which organs need to be examined. Always follow the instructions from your hospital, clinic or imaging department.

You may be asked to:

• avoid eating for several hours before the scan
• drink water before a bladder or pelvic scan
• avoid fizzy drinks before the appointment
• continue regular medicines unless told otherwise
• wear loose clothing that makes the abdomen easy to access

Fasting can help the gallbladder stay full and easier to assess. It can also reduce bowel gas, which may improve the view. Some hospitals ask patients to fast for around 6 hours before an abdominal scan, while still allowing certain clear fluids. The British Liver Trust notes that patients may be asked to fast for 6 hours before a liver ultrasound and avoid food, milk drinks, fizzy drinks and alcohol during that period. British Liver Trust ultrasound scan guidance.

Can you take medicines before the scan?

Most people can take regular medicines as usual with water, but you should follow your scan instructions. If you have diabetes and are asked to fast, ask for specific advice about diabetes medicines, insulin, food and drink timing.

If you are unsure whether to take a medicine, contact the imaging department or the clinician who referred you.

What happens during an abdominal ultrasound?

You will usually be asked to lie on an examination couch and expose the area being scanned. A sonographer, radiologist or trained clinician applies gel to your skin and moves the probe across your abdomen.

The gel may feel cold. The probe may press firmly at times, especially if the sonographer needs to see deeper organs or move bowel gas out of the way. You may be asked to take deep breaths, hold your breath briefly, roll onto your side or change position.

The scan is usually not painful, although pressure over a tender area may feel uncomfortable. Tell the sonographer if you are in pain.

The scan commonly takes around 15 to 30 minutes, but timing varies depending on what is being examined and how clear the images are.

Who performs the scan?

Abdominal ultrasound is usually performed by a sonographer, radiologist or another trained healthcare professional. The person performing the scan may not always be able to give a full result during the appointment, because images often need to be reviewed and formally reported.

The Royal College of Radiologists states that ultrasound examinations should be justified and that services should have clear guidelines about what is included in abdominal and pelvic ultrasound examinations, especially for vague or non-specific symptoms.

Will the sonographer tell you what they see?

This depends on local policy, the complexity of the scan and who is performing it. Sometimes the sonographer may say whether the scan looked straightforward. In other cases, they may explain that the report will be sent to the doctor who requested it.

Try not to panic if the sonographer is quiet or does not give details. They may need to concentrate, take measurements, capture images and follow reporting rules. Silence does not necessarily mean something is wrong.

When will you get results?

Results are usually sent to the doctor or clinician who referred you. NHS guidance says you may get ultrasound results at the end of the appointment, or it may take a few weeks depending on why the scan was done. If you have not heard anything after a few weeks, you should contact your GP surgery or specialist. NHS ultrasound results guidance.

Some hospital services report scans on the same day, but the referring doctor usually discusses the result with you. Guy’s and St Thomas’ advises that abdominal ultrasound scans are most often reported the same day and sent back to the referring doctor, who will discuss the report with the patient. Guy’s and St Thomas’ abdominal ultrasound information.

Before leaving, ask:

• When should I expect the report?
• Who will contact me?
• Should I book a GP or specialist follow-up?
• What should I do if I do not hear anything?

What might the report say?

Ultrasound reports often use medical language. They usually describe what was seen, whether anything looked abnormal, and sometimes whether further tests are recommended.

Common wording may include:

• Normal appearances: no significant abnormality seen in the scanned organs.
• Fatty infiltration of the liver: the liver looks brighter than expected, often linked with fatty liver.
• Simple cyst: a fluid-filled area that often has benign features.
• Gallstones: stones are seen in the gallbladder.
• No biliary dilatation: bile ducts do not look widened.
• Hydronephrosis: swelling of the kidney drainage system, suggesting possible obstruction.
• Limited views: some organs were difficult to see, often because of bowel gas or body habitus.
• Further imaging advised: CT, MRI or another test may be recommended.

If you are unsure what your report means, ask the referring clinician. Do not rely only on the wording of a report without considering symptoms, examination findings and blood tests.

Common finding: fatty liver

Fatty liver is a common ultrasound finding. It means the liver appears to contain more fat than expected. It can be linked with weight, insulin resistance, type 2 diabetes, high cholesterol, alcohol intake, some medicines and other factors.

Fatty liver does not always cause symptoms, and liver blood tests can be normal or abnormal. The important question is whether there is inflammation or scarring risk, which may need blood tests, lifestyle changes, further assessment or monitoring.

If your ultrasound mentions fatty liver, your GP may review alcohol intake, weight, blood pressure, HbA1c, cholesterol and liver blood tests. Related guides include liver function test results, HbA1c and blood sugar results, cholesterol blood test results and how weight loss really works.

Common finding: gallstones

Gallstones are common and do not always cause symptoms. If they are found incidentally and you have no typical symptoms, treatment may not be needed. If they cause repeated attacks of upper right abdominal pain, inflammation or blockage, surgery may be discussed.

Your doctor will interpret gallstones alongside your symptoms. Pain caused by gallstones is often in the upper right abdomen or upper middle abdomen, may come after meals, and may last minutes to hours.

Common finding: kidney cysts

Simple kidney cysts are common, especially with age. They are fluid-filled and often harmless. A report may describe a cyst as “simple” if it has reassuring features.

If a cyst looks complex, has solid areas, irregular walls, blood flow or other features, further imaging may be recommended. The word “cyst” alone is not enough to know whether follow-up is needed; the report details matter.

Common finding: enlarged spleen

An enlarged spleen can have many causes, including infections, liver disease, blood conditions and inflammatory conditions. If ultrasound shows spleen enlargement, your doctor will usually interpret it with blood tests, symptoms and examination findings.

Further tests may include a full blood count, liver tests, infection tests or specialist referral depending on the context.

What if the scan is normal but symptoms continue?

A normal ultrasound is reassuring but does not always explain symptoms. Many digestive conditions do not show on ultrasound, including reflux, functional indigestion, IBS, microscopic colitis, early bowel conditions, some ulcers and many food intolerances.

If symptoms continue, the next step depends on the pattern of symptoms and any red flags. Your doctor may consider:

• blood tests
• urine tests
• stool tests
• gastroscopy
• colonoscopy
• CT or MRI
• gynaecological assessment
• urology referral
• dietary review

For ongoing symptoms after a normal scan, relevant articles include IBS, heartburn and acid reflux, stomach ulcers and ovarian cysts.

Can ultrasound miss cancer?

Yes, ultrasound can miss some cancers, especially early, small or hidden cancers. It is not a whole-body cancer test. It can detect some tumours or suspicious changes, but a normal ultrasound does not rule out every cancer.

If you have red flag symptoms such as unexplained weight loss, persistent vomiting, difficulty swallowing, blood in stool, black stools, jaundice, unexplained anaemia, a persistent change in bowel habit or worsening abdominal pain, further assessment may still be needed even if ultrasound is normal.

For red flag symptom guidance, see unexplained weight loss, blood in stool, fatigue and abdominal pain.

Is abdominal ultrasound safe?

Yes. Diagnostic ultrasound is widely used and does not involve ionising radiation. It is generally safe, painless and non-invasive.

The main downsides are not radiation risks, but limitations of what it can see, possible discomfort from probe pressure, and the possibility of incidental findings that need follow-up.

Can you have an abdominal ultrasound while pregnant?

Ultrasound is commonly used in pregnancy. If an abdominal organ problem is suspected during pregnancy, ultrasound may be chosen because it does not use ionising radiation. Always tell the imaging department if you are pregnant or might be pregnant so the request and scan can be planned appropriately.

Private abdominal ultrasound: what to consider

Private abdominal ultrasound is widely available. It may be useful when arranged by a clinician for a clear reason, but be cautious with broad “wellness” scans that are not linked to symptoms, examination or blood test interpretation.

Before booking privately, ask:

• Who is requesting or interpreting the scan?
• Will the scan answer a specific clinical question?
• Who performs the scan?
• Is the sonographer or radiologist appropriately qualified?
• Who explains the results?
• Will your GP receive a report?
• What happens if something abnormal is found?
• Are follow-up tests included or separate?

If you are using private tests or scans, see NHS vs private healthcare in the UK, private GP services and what to do after abnormal private blood test results.

How to make the scan easier

Most abdominal ultrasounds are straightforward. A little preparation can make the appointment smoother.

• Read your appointment letter carefully.
• Follow fasting or drinking instructions exactly.
• Wear loose clothing that exposes the abdomen easily.
• Bring a list of medicines and relevant medical history.
• Tell the sonographer where your pain is.
• Say if pressing with the probe is too painful.
• Ask when and how you will receive results.
• Book follow-up with your GP or specialist if advised.

Questions to ask after an abdominal ultrasound

When you receive the result, it can help to ask:

• Was the scan normal?
• Were all organs seen clearly?
• Does the finding explain my symptoms?
• Is the finding common or concerning?
• Do I need blood tests, stool tests or urine tests?
• Do I need CT, MRI, gastroscopy or colonoscopy?
• Do I need treatment or monitoring?
• When should I seek urgent help?
• What happens if symptoms continue?

When to seek urgent medical help

Do not wait for a routine ultrasound appointment if you have severe or rapidly worsening symptoms.

Seek urgent medical advice if you have:

• severe abdominal pain
• abdominal pain with fever or feeling very unwell
• yellow skin or eyes
• vomiting blood
• black, tarry stools
• persistent vomiting and dehydration
• fainting or collapse
• severe pain spreading to the back
• a pulsating abdominal mass
• blood in urine with severe pain
• unexplained weight loss with worsening symptoms

Call 999 if symptoms are severe, you collapse, have severe chest pain, severe breathlessness, signs of stroke, or heavy bleeding.

Final thoughts

An abdominal ultrasound is a safe, useful and commonly requested scan. It can show gallstones, liver changes, kidney swelling, cysts, bile duct problems, spleen enlargement, fluid in the abdomen and some aortic problems. It can help doctors decide whether symptoms or blood test changes need treatment, monitoring or further investigation.

However, ultrasound does not show everything. It is limited by bowel gas, body habitus and the type of condition being investigated. A normal scan may be reassuring, but it does not always explain pain, bowel symptoms, reflux, anaemia or weight loss. Further tests such as blood tests, stool tests, CT, MRI, gastroscopy or colonoscopy may still be needed depending on the clinical picture.

For official information, see the NHS guide to ultrasound scans, Guy’s and St Thomas’ guide to abdominal ultrasound, and NHS Inform’s guide to ultrasound scans.

This article is for general information only and should not replace medical advice. Always follow the instructions from your hospital, imaging department or clinician, especially about fasting, medicines and follow-up.

Frequently asked questions

What is an abdominal ultrasound?

An abdominal ultrasound is a scan that uses sound waves to create images of organs inside the abdomen. It does not use X-rays and is usually painless.

What organs does an abdominal ultrasound show?

It can show the liver, gallbladder, bile ducts, kidneys, spleen, abdominal aorta and sometimes parts of the pancreas and bladder, depending on the scan requested.

Why would a GP request an abdominal ultrasound?

A GP may request it for abdominal pain, suspected gallstones, abnormal liver tests, kidney symptoms, jaundice, abdominal swelling, unexplained weight loss or follow-up of an abnormal test result.

Can ultrasound show gallstones?

Yes. Ultrasound is one of the best first tests for gallstones. It can also show gallbladder inflammation, sludge, polyps and bile duct widening in some cases.

Can ultrasound show fatty liver?

Yes, ultrasound can suggest fatty liver if the liver looks brighter than expected. However, blood tests and clinical assessment are needed to understand the cause and whether there is inflammation or scarring risk.

Can ultrasound detect bowel cancer?

Ultrasound is not the main test for bowel cancer. Colonoscopy, CT and bowel screening tests are usually more useful. A normal abdominal ultrasound does not rule out bowel cancer if red flag symptoms are present.

Can ultrasound show stomach ulcers?

No, stomach ulcers are usually not seen well on abdominal ultrasound. Gastroscopy is the test that looks directly inside the stomach and can diagnose ulcers.

Do I need to fast before an abdominal ultrasound?

You may be asked to fast for several hours, especially if the liver, gallbladder or bile ducts are being scanned. Follow your appointment instructions exactly, as preparation varies.

Can I drink water before an abdominal ultrasound?

Often yes, but it depends on the scan. Some scans require fasting but allow water. Others, especially pelvic or bladder scans, may ask you to drink water and attend with a full bladder. Follow your appointment letter.

Is an abdominal ultrasound painful?

It is usually not painful. You may feel pressure from the probe, especially if the sonographer presses over a tender area. Tell them if it is too uncomfortable.

How long does an abdominal ultrasound take?

Most scans take around 15 to 30 minutes, although this can vary depending on what is being examined and how clear the images are.

Will I get results straight away?

Sometimes, but not always. The report is usually sent to the doctor who requested the scan. You may need a follow-up appointment to discuss the result and next steps.

What does “limited views” mean on an ultrasound report?

It means some areas were difficult to see clearly. This is often due to bowel gas, body shape, pain or organ position. Your doctor will decide whether further imaging is needed.

What happens if the ultrasound finds something abnormal?

It depends on the finding. Some abnormalities are harmless and need no treatment. Others may need blood tests, repeat ultrasound, CT, MRI, gastroscopy, colonoscopy or specialist referral.

Is abdominal ultrasound safe?

Yes. Diagnostic ultrasound is widely used and does not involve ionising radiation. It is generally considered safe and non-invasive.