Abdominal Ultrasound: Preparation, What the Doctor Sees and Results
Patient Guide · Reviewed by a Specialist · Colombia 2026
Abdominal ultrasound: what it is, how to prepare, and how to read the report step by step
Everything you need to know about abdominal ultrasound in Colombia — what is examined, how to prepare correctly, what the terms in the report mean, and when to worry about the results
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Reviewed by the GSMED Imaging medical team
Specialists in diagnostic imaging and abdominal ultrasound. Content based on RadiologyInfo (ACR/RSNA), MedlinePlus NIH, SEMERGEN (Abdominal Ultrasound Course), FEHV Clinic, and the International Hospital of Colombia (HIC). Reviewed for terminology and Colombian clinical context.
ℹ️ Medical notice: This guide is for informational and educational purposes. The results of your ultrasound must be interpreted by the doctor who ordered it or by the radiologist who performed it, always in the context of your medical history. This information does not constitute a medical diagnosis. If you have questions about your results, consult your treating physician directly.
The doctor told you, "I'm going to order an abdominal ultrasound," and you left the appointment with an order but didn't really understand what they were going to do or why. Or you already have the results in hand and the report says things like "hyperechoic liver parenchyma" or "anechoic image with posterior acoustic enhancement" and you don't know if that is serious or not. This guide exists so you can arrive at your next medical appointment knowing exactly what they are talking about.
1. Ultrasound, sonography, sonogram: are they the same?
Yes. In Colombia — and throughout Latin America — these three terms are used interchangeably to refer to exactly the same exam:
- Sonogram: the term most commonly used colloquially by Colombian patients and many primary care doctors. It comes from "echo" (the physical principle of sound reflection) + "gram" (image or record). It is correct and clinically valid.
- Sonography: the most common technical term in Spanish medical literature.
- Ultrasound or ultrasonography: the most commonly used technical term in English-language literature, referring to the type of sound wave used.
If your doctor wrote "abdominal sonogram," "abdominal sonography," or "abdominal ultrasound" on the order, they are ordering exactly the same exam. There is no technical difference between them — it is just vocabulary.
What an abdominal ultrasound does — in one line It emits high-frequency sound waves into the abdomen and records the echoes that bounce off the organs, converting that information into real-time images of your internal organs. No X-rays. No radiation. No pain. No invasion of the body.
0
Ionizing radiation — completely safe for adults, children, and pregnant women
20–40
minutes is how long a complete abdominal ultrasound takes
8 h
of fasting is the minimum needed to clearly see the gallbladder
10+
structures evaluated in a complete abdominal ultrasound
2. Why did they order the ultrasound? The most common reasons
The abdominal ultrasound is the most requested imaging test in general medical consultations in Colombia. Your doctor may have ordered it for several reasons:
| Symptom or reason | What the doctor looks for on the ultrasound | Main organ |
|---|---|---|
| Pain in the right side, especially after eating | Gallstones (cholelithiasis), gallbladder inflammation (cholecystitis) | Gallbladder |
| Elevated liver enzymes in the blood | Fatty liver (steatosis), hepatitis, cirrhosis, cysts, or liver masses | Liver |
| Lower back pain or "kidney pain" | Kidney stones, hydronephrosis, kidney cysts, kidney infection | Kidneys |
| Distension or "bloated belly" | Free abdominal fluid (ascites), enlarged organs, gas | General abdomen |
| Monitoring for diabetes or chronic hypertension | Chronic kidney damage, metabolic fatty liver, organ size | Kidneys · Liver |
| Preventive health checkup | Rule out silent pathologies: fatty liver, asymptomatic stones, aortic aneurysm | Entire abdomen |
| Pelvic pain (women) | Ovarian cysts, uterine fibroids, pelvic pathology (if the pelvic area is included) | Uterus · Ovaries |
| Prostate symptoms (men) | Prostate size, post-void residual | Prostate · Bladder |
3. How to prepare correctly: the step most patients get wrong
Preparation for an abdominal ultrasound has two parts with different instructions. The most common mistake in Colombia is arriving without the correct preparation, which requires rescheduling the exam:
🟡 Upper abdomen — mandatory FASTING
- At least 8 hours of fasting before the exam — no solid or liquid foods (except small amounts of water to take medications)
- The night before: eat an early, light dinner before 7 p.m., without fats or dairy — fats cause the gallbladder to contract, making stones harder to see
- Your medications: you can take them with the smallest possible sip of water — consult your doctor if you take insulin
- No smoking or chewing gum on the day of the exam — they stimulate the production of intestinal gas that blocks the image
- Why fast? The gallbladder full of bile is distended — stones are clearly visible. After eating, the gallbladder contracts and stones can be hidden
🟢 Pelvic area (if included) — FULL BLADDER
- Drink 4 to 6 glasses of water (approximately 1 liter) starting 1 hour before the exam
- Do not urinate from the time you start drinking the water until the technician tells you that you can
- Why a full bladder? A bladder filled with liquid acts as an ultrasound "window" — it allows the uterus, ovaries, and prostate, which are located right behind it, to be seen. With an empty bladder, it is impossible to see them
- If your doctor only ordered an "abdominal ultrasound" (without the pelvic area), you do not need a full bladder — only fasting
- If you have an extreme urgency, let the technician know when you arrive so they can plan the order of the study
If you already have the ultrasound ordered but don't know if it includes the pelvic area Look at your medical order: if it says "complete abdominal ultrasound," "abdominal-pelvic ultrasound," or "ultrasound of the abdomen and pelvis," you need BOTH preparations — fasting and a full bladder. If it says only "abdominal ultrasound" or "upper abdominal ultrasound," you only need fasting. When in doubt, call the diagnostic center before going.
4. What the ultrasound evaluates: the organs the radiologist sees
A well-performed complete abdominal ultrasound systematically examines these organs and structures. Each one has normal size and appearance values that the radiologist knows by heart:
| Organ | What is evaluated | Normal reference size | Common finding |
|---|---|---|---|
| Liver | Size, parenchyma echostructure, borders, focal lesions | Right lobe < 16 cm in adults | Fatty liver, cysts, hemangiomas |
| Gallbladder | Size, wall thickness, contents, stones | Wall < 3 mm · Fasting: 7–10 cm | Gallstones, cholecystitis |
| Biliary tract | Common bile duct — diameter, obstruction | Common bile duct < 6–7 mm | Dilation due to choledocholithiasis |
| Pancreas | Size, echostructure, Wirsung duct | Head < 3 cm · Wirsung < 2 mm | Pancreatitis, cysts (difficult due to gas) |
| Spleen | Size, focal lesions, splenomegaly | Maximum length < 12 cm | Splenomegaly (portal hypertension) |
| Kidneys | Size, cortex, renal pelvis, stones, cysts | 9–13 cm length | Stones, hydronephrosis, simple cysts |
| Abdominal aorta | Diameter — rule out aneurysm | Normal diameter < 3 cm | Aortic aneurysm (vascular emergency) |
| Bladder (with full bladder) | Shape, wall, post-void residual, stones | Distended wall < 5 mm | Bladder stones, bladder tumor |
| Uterus and ovaries (women) | Size, endometrium, fibroids, ovarian cysts | Uterus: 7–9 × 4–5 × 3–4 cm | Fibroids, ovarian cysts |
| Prostate (men) | Volume, echostructure, nodules | < 30 cc in those under 50 years | Benign prostatic hyperplasia |
5. How to read the report: the glossary no one gives you
The ultrasound report is written in technical radiological language that can be difficult to understand without help. These are the terms that most frequently cause confusion — explained in simple language:
Anechoic / Anechogenic
It looks: dark black on the image
It means that the structure does not reflect echoes — the ultrasound waves pass through it without bouncing back. This occurs in pure liquids such as bile, urine, the fluid in a simple cyst, or the contents of blood vessels.
Example in report: "2 cm anechoic image in the kidney" = cyst with pure fluid (almost always benign)
Hyperechoic / Hyperechogenic
It looks: bright, intense white
That structure reflects more ultrasound than normal — it appears brighter than the surrounding tissues. In the liver, generalized hyperechogenicity is the typical finding of fatty liver. Calcifications and stones are hyperechogenic.
Example in report: "hyperechoic liver parenchyma" = likely fatty liver
Hypoechoic / Hypoechogenic
It looks: dark gray, darker than normal tissue
That structure reflects less ultrasound than the tissue surrounding it — it appears darker. Complex cysts, abscesses, and some tumors are hypoechoic. It is not automatically synonymous with seriousness — it depends on the context.
Example in report: "hypoechoic lesion in the liver" = requires additional characterization
Isoechoic / Isoechogenic
It looks: the same as the surrounding tissue
That structure has the same echogenicity as the tissue surrounding it — it is difficult to distinguish it on the grayscale image. Some isoechoic lesions are only detected because they distort the contour of the organ or by their Doppler vascularization.
Example: small isoechoic lesions can be difficult to detect on ultrasound
Posterior acoustic enhancement
It looks: brighter area behind the lesion
When ultrasound passes through a structure filled with liquid (which does not attenuate the waves), the waves that follow behind are more intense — a brighter area appears behind. It is a sign that the lesion contains pure liquid → simple cyst.
Example in report: "anechoic image with posterior acoustic enhancement" = benign simple cyst
Posterior acoustic shadow
It looks: dark area behind the lesion
When ultrasound hits a very dense structure (calcification, stone, bone), it reflects completely — it does not pass through to the back. A dark shadow appears. The acoustic shadow behind a bright focus = stone. It is the key diagnostic sign of gallstones and kidney stones.
Example in report: "hyperechoic image with posterior acoustic shadow" = gallstone or kidney stone
More report terms you should know
| Term in the report | What it means in simple language | Usual context |
|---|---|---|
| Focal lesion / LOE (lesion occupying space) | Area clearly different from the rest of the organ — can be a cyst, benign or malignant tumor, abscess, etc. It does not automatically imply malignancy. | Liver, kidney, spleen |
| Homogeneous parenchyma | The organ tissue has a uniform appearance — a sign of normality | Liver, kidney, spleen |
| Heterogeneous parenchyma | The tissue has areas of different echogenicity — it can be normal in some organs or a sign of disease | Liver (cirrhosis), thyroid |
| No significant alterations | The radiologist did not find anything important to report — the organ appears normal | Any organ |
| Hepatic steatosis / fatty liver | Fat accumulation in the liver — appears hyperechoic. Very common in people with overweight, diabetes, or dyslipidemia | Liver |
| Dilation of the collecting system | The kidney's drainage system is enlarged — it can indicate obstruction by a stone or another cause | Kidney |
| Lithiasis / cholelithiasis / nephrolithiasis | Stones: in the gallbladder or in the kidney respectively | Gallbladder, kidney |
| Ascites / free fluid | Fluid within the abdominal cavity where it should not be — requires investigation of the cause | Peritoneal space |
| Splenomegaly / hepatomegaly | Enlargement of the spleen or liver beyond normal values | Spleen, liver |
| Requires completion / CT scan suggested | Any indeterminate finding |
6. How an ultrasound report is structured: the three parts that matter
📄 Typical structure of an abdominal ultrasound report in Colombia
Part 1 — Study details
Administrative information: patient name, date, type of study performed, equipment used. Some reports also include the clinical indication (why the ultrasound was ordered). This part does not contain diagnostic information.
Part 2 — Findings by organ (the technical part)
The radiologist describes what they saw in each organ examined, using technical vocabulary. This is the longest part and contains the terms from the previous glossary. A real example of what it might look like:
"Liver: normal size, parenchyma with diffusely increased echogenicity, compatible with mild hepatic steatosis. No focal lesions observed. Hepatic veins appear normal. Gallbladder: distended, thin walls. An 8 mm hyperechoic image with posterior acoustic shadowing is observed inside, compatible with gallstones. Main bile duct: normal caliber (5 mm). Pancreas: not adequately visualized due to bowel gas. Spleen: normal size and echostructure (11 cm). Right kidney: normal size and morphology (10.5 cm). 15 mm anechoic image with posterior acoustic enhancement in the upper pole, compatible with a simple cortical cyst. Left kidney: normal (10 cm). Abdominal aorta: normal caliber (2 cm)."
Part 3 — Diagnostic impression / Conclusion (the most important)
The radiologist summarizes the most relevant findings in clearer language and makes follow-up recommendations. This is the section your doctor will read first. Example:
"1. Mild hepatic steatosis. 2. Single 8 mm gallbladder stone. 3. 15 mm simple cortical cyst in the right kidney — no features of malignancy. 4. Pancreas not evaluable due to bowel gas. Completion with CT scan is suggested, or repeat with strict 12-hour fasting if pancreatic evaluation is required."
How to read your report in 30 seconds Go directly to the diagnostic impression or conclusion — that section summarizes everything important. If it says "no pathological findings," "no significant abnormalities," or "study within normal limits," the ultrasound was normal for what was being looked for. If it mentions any finding, your doctor will explain what it means and what the next step is.
7. Does a normal ultrasound mean I am completely healthy?
A normal ultrasound is very good news — but it has real limitations that your doctor knows and that you should understand so as not to create false expectations in any way:
- Bowel gas blocks some structures: the pancreas is the organ most frequently "not evaluable" on ultrasound, because gas in the intestine acts as a wall that reflects the ultrasound. A report that says "pancreas not visualized due to bowel gas" does not mean the pancreas is bad — it means the gas did not allow it to be seen. If the doctor needs to evaluate the pancreas, they will order a CT scan.
- Small lesions may not be seen: ultrasound has a sensitivity that depends on the size of the lesion, its position, and the quality of the equipment. Very small masses (<5–10 mm in some organs) may not be visible on ultrasound and may be detected on CT or MRI.
- It does not detect all intestinal diseases: ultrasound cannot see inside the intestine like a colonoscopy or endoscopy can. Inflammatory bowel disease or early-stage colon cancer may not be seen on ultrasound.
- It depends on the operator: the quality of the ultrasound depends significantly on the experience of the sonographer and the quality of the equipment used. In Colombia, there are important differences between diagnostic centers in terms of technology and staff training.
What a "no findings" report does tell you An abdominal ultrasound with no pathological findings means that the organs examined — the ones that were visible — appeared normal at that time and with that technology. It does not absolutely rule out every possible abdominal pathology. If your symptoms persist after a normal ultrasound, tell your doctor — you may need additional tests.
8. These warning signs should not wait for the ultrasound results
⚠️ Seek emergency care if you have any of these symptoms while waiting for the ultrasound
Severe and sudden abdominal pain that does not subside with pain relievers
Abdomen hard as a board ("board-like abdomen") — possible perforation
Vomiting blood or tarry black stools
High fever with chills and pain in the right side
Jaundice (yellowing of the skin and eyes) with rapid onset
Syncope or very low blood pressure with abdominal pain
9. Frequently asked questions about abdominal ultrasound
Does an abdominal ultrasound hurt?
No. It is completely painless. Cold gel is applied to the abdomen and a probe is gently slid over the skin. The only thing you may feel is the slight pressure of the transducer and the coldness of the gel — which some centers now warm beforehand. If you have a recent injury or a very sensitive area, you may feel some discomfort when the technician presses on that area, but it is not an exam that hurts.
Can I have an ultrasound if I am taking medications?
Yes, generally you can take your usual medications with the smallest possible sip of water. The important exception is insulin: if you use insulin and will be fasting for the ultrasound, consult your doctor beforehand about how to manage the dose that day to avoid hypoglycemia. Some medications that produce bowel gas (such as metformin) may make it difficult to visualize the pancreas — inform the radiologist about the medications you take.
Can an abdominal ultrasound detect cancer?
Ultrasound can detect masses, nodules, or focal lesions in the liver, kidney, bladder, ovaries, and other organs that could be tumors — benign or malignant. However, ultrasound does not diagnose cancer on its own. If a suspicious lesion is detected, the radiologist will recommend a contrast CT scan, an MRI, or a biopsy for definitive characterization. A normal ultrasound also does not completely rule out cancer — some small tumors or those in difficult locations are not visible on ultrasound.
How long do ultrasound results take in Colombia?
It depends on the center. In many private diagnostic centers in Colombia, the report is ready the same day or within the first 24 hours. In public hospital centers, it may take longer. The technician who performs the study may give you general impressions at the end, but the official signed report is issued by the radiologist. If there is an urgent finding (large mass, massive ascites, aortic aneurysm), the radiologist will contact the doctor who ordered the study directly without waiting for the formal report.
How much does an abdominal ultrasound cost in Colombia in 2026?
The cost varies depending on the type of institution and the city. In the Colombian health system (EPS/IPS), ultrasound is covered by the Health Benefits Plan (PBS) when ordered by the treating doctor — at no additional cost to the patient. In private consultation or private centers, the price in 2026 ranges between $80,000 and $200,000 COP for a simple abdominal ultrasound, and between $150,000 and $300,000 COP for a full abdominal ultrasound with pelvic part and Doppler. Prices vary significantly between Bogotá, Medellín, Cali, and intermediate cities.
How often should I have a follow-up abdominal ultrasound?
There is no universally recommended frequency for the healthy general population. Your doctor will tell you the frequency according to your individual situation. Some examples: patients diagnosed with fatty liver → annual follow-up or according to progression; simple renal cysts → follow-up every 1–3 years; asymptomatic gallstones → follow-up according to the specialist's criteria; diabetes or hypertension with organ damage → generally annually. Do not self-order follow-up ultrasounds without medical indication — the incidental finding of something that had no meaning can create an unnecessary cascade of tests and anxiety.
Does your institution need to improve the quality of ultrasound diagnosis?
At GSMED, we have high-resolution ultrasound machines for abdominal diagnosis available in Colombia, with local technical support, training included, and financing.
Accurate abdominal diagnosis begins with the right ultrasound machine
High-definition abdominal ultrasound machines with color Doppler available in Colombia — local technical support and financing available.
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