Complete abdominal ultrasound report template (normal)
The most requested exam in daily practice. The template below describes each organ in one sentence, with "normal appearance" as the standard for normality, and the abnormal example shows two common findings written objectively.
COMPLETE ABDOMINAL ULTRASOUND
TECHNIQUE:
Real-time transabdominal examination with a convex transducer.
FINDINGS:
Liver of normal size, with regular contours and sharp edges. Parenchyma with homogeneous echotexture and normal echogenicity.
Patent portal vein of normal caliber and course.
Normally distended gallbladder with thin walls and anechoic content.
Intrahepatic and extrahepatic bile ducts of normal caliber.
Pancreas of normal size and echotexture in the visualized portions.
Spleen of normal shape, contours and size, with homogeneous echotexture.
Kidneys in normal position, of normal size and contours, with preserved parenchymal thickness and echogenicity and preserved corticomedullary differentiation. No evidence of stones or collecting system dilatation.
Well-distended bladder with thin walls and anechoic content.
Abdominal aorta of normal caliber in the segments assessed.
No free fluid in the cavity.
IMPRESSION:
Normal complete abdominal ultrasound.
FINDINGS:
Liver of normal size, with a mild diffuse increase in parenchymal echogenicity.
Normally distended gallbladder with thin walls, containing multiple mobile stones, the largest measuring 1,2 cm, with posterior acoustic shadowing.
IMPRESSION:
Mild hepatic steatosis.
Cholelithiasis.
Fields in brackets are filled in from the exam. The template is a starting point: the report must reflect what was seen and your practice's guidelines.
Frequently asked questions
What is the difference between complete and upper abdominal ultrasound?
Is fasting required?
Other report templates
Stop copying templates: let the report write itself.
Structured templates, automatic calculations and classifications, PACS and scheduling with WhatsApp. 15 days free, no card.