Abdominal ultrasound is  an integral part of the diagnostic decision making process in the sense of clinical ultrasonography – which means  that an ultrasound examination performed by the clinician would follow directly on from history taking and physical examination in any patient with symptoms suggestive of abdominal disease. Ultrasonography might be repeated by the clinician whenever it is felt to be needed in the course of the disease, making use at any time of the realtime informaton. Moreover, ultrasonography provides pictures of the highest resolution level in parenchymatous organs known for any imaging method.

The advantages are obvious: improvements in the time-scale for achieving a given diagnosis in a given case, avoidance of unnecessary, costly or even risky procedures etc all of which can lead to significant financial savings.  

It is of course axiomatic that - to achieve the smooth integration of available ultrasound information into the patient’s management -  the clinician has  appropriate experience of the procedure. 

This, however, is far less of a problem than other groups (e.g., radiologists) with an invested interest in imaging modalities might suggest. And clinical ultrasonography is - in my eyes - this much an integrated part of the patient`s physical examination - extending palpation and the stethoscope - that I would not leave it  to  assisting persons.

Abdominal ultrasound is easy providing one has a good knowledge of  anatomy (including topographical understanding), and some enthusiasm in creating three dimensional realtime volumes from the initial two dimensional scanning planes. 

The following four parts – with text and pictures including a selection of pathology - may be  helpful  in guiding the clinician`s first steps into the beautiful and exciting world of performing abdominal ultrasound him- or herself.

Armed with the scanning probe in one hand and the patient’s abdomen in the other, and eyes on the fascinating pictures that begin to unfold on the screen let us now go forward - abdominal ultrasound is beautiful !