What is the diagnosis for a patient with a normal abdominal ultrasound?

From the Guidelines

The patient's abdominal ultrasound results are completely normal, indicating no evidence of disease, inflammation, obstruction, or abnormal growths, and therefore, no further imaging or intervention is needed based on these results. The liver is normal in size and echotexture with no focal lesions, the gallbladder has thin walls and no stones, and the bile ducts are not dilated, with the common bile duct measuring a normal 3 mm 1. The pancreas appears normal with no surrounding fluid, and the spleen size is slightly below the normal range (normal range is approximately 11-13 cm in length for adults) but still within a relatively normal limit at 8 cm. The abdominal aorta measures a normal 1.3 cm in diameter, and both kidneys are of normal size (right 11.5 cm, left 11.7 cm) with no signs of hydronephrosis (fluid backup) or kidney stones. Some key points to consider in the interpretation of these results include:

• The absence of free fluid in the abdomen (ascites) and the normal appearance of the abdominal organs suggest that there is no significant intra-abdominal injury or disease process present 1.
• The normal size and echotexture of the liver, gallbladder, pancreas, and kidneys suggest that these organs are functioning properly and are not affected by any disease process.
• The normal diameter of the abdominal aorta suggests that there is no significant aortic disease present.
• The lack of hydronephrosis or kidney stones in the kidneys suggests that the urinary tract is functioning properly and that there is no obstruction or disease process affecting the kidneys. Overall, the patient's abdominal ultrasound results are normal, and no further imaging or intervention is needed based on these results.

From the Research

Ultrasound Findings

• The liver is normal in size and echotexture with no focal lesions
• The gallbladder is thin-walled with no stones
• No dilated intrahepatic ducts, with a common bile duct (CBD) measuring 3 mm
• The pancreas appears normal with no fluid in the lesser sac
• The spleen measures 8 cm, which may be considered splenomegaly as studies have shown that a normal spleen size is typically less than 13 cm in length 2
• The abdominal aorta measures 1.3 cm
• The right kidney measures 11.5 cm and the left kidney measures 11.7 cm
• No hydronephrosis or renal calculi are present
• No ascites is observed

Splenomegaly

• The spleen size of 8 cm may be indicative of splenomegaly, which can be caused by various factors including drug-induced splenomegaly 3
• Studies have shown that point-of-care ultrasonography can improve the diagnosis of splenomegaly in hospitalized patients 4
• The diagnosis of splenomegaly due to drugs is based on a recent history of exposure to a drug before the spleen enlargement 3
• Differentiating between benign and malignant etiologies of splenomegaly based on stiffness differences observed in ARFI elastography is not feasible 5

Diagnostic Techniques

• Physical diagnostic techniques for the detection of splenomegaly are relatively insensitive but specific, with high interobserver variability 2
• Combining physical diagnostic tests, such as palpation and percussion, can increase diagnostic accuracy 2
• Point-of-care ultrasonography significantly improves examiners' sensitivity in diagnosing splenomegaly 4