Patient Preparation

Patient Preparation for Liver Ultrasound

Proper preparation improves the accuracy of a liver ultrasound by reducing bowel gas and enhancing sound wave penetration. Here are the standard guidelines:
1. Fasting Requirements

• Fasting Duration:6–8 hours before the exam.
• Reason: Reduces bowel gas and allows the gallbladder to remain distended for better visualization of adjacent liver structures.

2. Medications

• Patients may continue regular medications with a small amount of water, unless otherwise instructed by their physician.

3. Hydration

• Dvoid excessive fluid intake before the exam (especially carbonated drinks), as it may increase bowel gas and obscure liver structures.

4. Dietary Instructions
Diabetic patients: TMay need individualized instructions to balance fasting with glucose control. Emergency cases: Preparation may be limited or skipped based on clinical urgency.
5. What to Wear:

• Wear comfortable, loose-fitting clothing.
• You may be asked to change into a gown during the procedure.

6. During the Exam:

• The procedure usually takes 15–30 minutes.
• A warm gel will be applied to your abdomen, and a transducer will be moved over the area.
• The exam is non-invasive and painless.

7. After the Exam:

• You may resume normal activities and diet unless otherwise instructed.
• Your results will be sent to your doctor for review.

Positioning & Techniques

Positioning Techniques for Liver Ultrasound

Proper positioning is crucial for optimal visualization of liver anatomy and pathology during sonographic examination. Here are standard and advanced positioning techniques used in liver ultrasound:
1. Supine Position (Standard)

• Patient lies flat on their back.
• Most common starting position for liver ultrasound.
• Transducer is placed subcostally or intercostally in the right upper quadrant.
• Used to assess the entire liver, portal and hepatic veins, and surrounding structures.

2. Left Posterior Oblique (LPO) or Left Lateral Decubitus (LLD)

• Patient lies on their left side.
• Allows the liver to fall forward, increasing the acoustic window between the ribs.
• Enhances visualization of the right lobe, especially for obese patients or those with rib shadowing.
• Useful for evaluating the right kidney-liver interface and posterior segments of the right lobe.

3. Right Posterior Oblique (RPO) or Right Lateral Decubitus (RLD)

• Patient lies on their right side.
• Less commonly used but helpful for left lobe assessment.
• May improve access to caudate lobe and ligamentum venosum.

4. Sitting or Upright Position

• Patient sits upright or leans forward.
• Useful when bowel gas or obesity obscures liver visualization.
• Gravity assists in moving bowel loops inferiorly and liver superiorly.

5. Deep Inspiration Technique

• Instruct patient to take and hold a deep breath.
• Moves the liver inferiorly, improving access to the subcostal and intercostal windows.
• Enhances Doppler flow assessment of hepatic vessels.

6. Subcostal and Intercostal Approaches

• Subcostal: Probe angled under the costal margin.
• Intercostal: Probe placed between the ribs, usually in coronal or oblique orientation.
• Intercostal scanning helps avoid rib shadowing and visualize deeper segments.

7. Prone or Semi-Prone Position

• Rarely used, but may help assess posterior liver lesions or in interventional procedures.

8. Arm Position

• Ask patient to raise their right arm above the head.
• This stretches the intercostal spaces and improves access to the right upper quadrant

Summary Table: Liver Ultrasound Positioning Techniques

Position	Usefulness
Supine	Standard view of liver
LLD (Left Lateral Decubitus)	Right lobe access, reduces rib shadow
RLD (Right Lateral Decubitus)	Better left lobe view
Upright	Displaces bowel gas
Deep Inspiration	Brings liver below rib cage
Subcostal/Intercostal	Targets deeper/posterior segments

Patient History and Consent

Liver Ultrasound - Patient History & Consent

Patient History and Consent for Liver Ultrasound

Full Name: Age / Sex: Clinical Indication: Relevant Medical History: Surgical History: Current Symptoms:

Consent Statement:

I understand that a liver ultrasound is a non-invasive imaging procedure using sound waves to examine the liver. It is painless and involves no radiation exposure. I have had the opportunity to ask questions and consent to proceed with the procedure.

I have read and agree to the above statement.