What does an ultrasound scan of the pancreas diagnose?

A pancreatic ultrasound (or sonogram) uses sound waves to produce images of the pancreas. You may need this test if you have symptoms or risk factors for pancreatic disease. There are several different types of diagnostic methods for pancreatic ultrasound. Pancreatic ultrasound is sometimes used during interventional treatment of pancreatic diseases.

Reasons why doctors prescribe ultrasound of the pancreas

Pancreatic ultrasound can be used to evaluate inflammation, abnormal growths, or blocked ducts affecting the pancreas.

Your healthcare providers may order an ultrasound of your pancreas if they think you may have:

Some symptoms that may indicate the need for a pancreatic ultrasound include:

• Bloating (enlarged abdominal area)
• Abdominal pain or discomfort
• Constipation, diarrhea or other bowel problems.
• High temperature
• Jaundice (yellow discoloration of the eyes and skin, indicating high bilirubin levels)
• Nausea, vomiting
• Unexpected weight loss

Typically, pancreatic disease causes a combination of these symptoms, not just one. Your health care providers will review your symptoms, medical history, and risk factors and perform a physical examination before deciding what imaging or other diagnostic tests to give you.

If you have an ultrasound of your pancreas, you will likely need other diagnostic tests, which may include:

Other imaging tests you may also need as part of your evaluation include magnetic resonance imaging (MRI) of the pancreas, liver imaging, or colonoscopy, since pancreatic disease is often associated with liver or colon disease.

Test limitations

Pancreatic ultrasound can help visualize signs of inflammation or tumor in the pancreas and detect pancreatic duct obstruction.

However, the pancreas is an irregularly shaped organ and its location is difficult to access. Because of these structural and anatomical features, sometimes pancreatic abnormalities cannot be detected by pancreatic ultrasound.

Normal and abnormal results

Pancreatic ultrasound can be used to monitor certain changes in the pancreas that may indicate inflammation, infection, blockage, cysts, or cancer. However, although this test can often identify problems, it cannot completely rule out pancreatic disease as it may be difficult to completely visualize the pancreas even with the use of good quality ultrasound and careful image evaluation.

Some abnormal changes that may be noted on pancreatic ultrasound include:

• Cysts (one or more)
• Liquid
• Growths that may be cancerous
• Inflammation
• Pancreatic duct obstruction

If you are having a pancreatic ultrasound, your doctor and radiologist will need to carefully review your test images when considering your diagnosis. Usually the test itself does not give a clear answer. Therefore, your medical team will review the images in light of your overall health to be able to interpret any abnormalities.

How does the ultrasound preparation and process work?

You may be asked to prepare in advance for an ultrasound of your pancreas. Preparation may include limiting food and drink for a certain time. You may be advised to drink a special liquid in preparation for the test.

The day before the procedure

The specific instructions you receive before your pancreatic ultrasound will depend on whether you are having an abdominal ultrasound or an endoscopic pancreatic ultrasound.

You can usually continue with your normal diet during an ultrasound of your abdomen and pancreas. For an endoscopic ultrasound of the pancreas, you will need to fast from food and drink for about 12 hours before the procedure.

Fasting before endoscopic examination serves the following purposes:

• Having an empty stomach and intestines helps the doctor see your digestive system better during the exam.
• Keeping food and drink in the stomach helps prevent vomiting when the endoscope is placed down the throat.

Day of procedure

On the day of the ultrasound, go to the facility where you will be tested. If you are having an invasive procedure, you will need someone to drive you to and from the test. If you are having a non-invasive procedure (such as an abdominal ultrasound), you may be able to drive yourself there and home.

When you show up for your procedure, you must register or log in, provide your insurance information, and verify your identity (to ensure you are taking the correct test that was assigned to you).

You will be taken to the patient locker room where you will be given a gown to change into. You will be asked to place your clothing and personal items in a locker. Your health care providers may check your vital signs and ask you to sign a consent form before the test.

If you are having an abdominal ultrasound, the procedure may take 15 to 30 minutes. The procedure may take more than an hour if you are having an endoscopic ultrasound or therapeutic procedure.

Typically, with an invasive procedure, you can expect to take medications to reduce discomfort. This medicine may cause drowsiness. It may take several hours for this medication to wear off, and you may need to rest at home after the procedure.

After an invasive procedure or if you are taking pain medication, you will be monitored for a short time to make sure you are alert and recovering and to monitor for side effects such as bleeding before you are discharged home.

If you begin to experience discomfort, pain, vomiting blood, nausea, or vomiting, contact your doctor and report your symptoms.

Aftercare

An abdominal ultrasound should not cause any post-test symptoms or side effects. Until you are diagnosed and treated, you will most likely continue to have the same symptoms that you had before you were tested – these are the symptoms you are being tested for.

If you have had an endoscopic ultrasound, you may have a sore throat for several hours or even several days after the procedure. You may also experience abdominal discomfort.

If you have a needle inserted or a surgical incision made as part of your treatment, you will need to follow wound care instructions and consult with your healthcare provider to check the incision.

You can also expect to begin treatment for a pancreatic disease such as pancreatitis or pancreatic cancer.

Additional tests with abnormal ultrasound

Depending on the results of the pancreatic ultrasound, you may need additional diagnostic tests. Additional testing may include other imaging tests to evaluate the liver, stomach, colon, or other abdominal structures.

In some cases, a biopsy may be required. This is an invasive diagnostic procedure in which your doctor surgically removes a small sample for analysis under a microscope. If the pancreatic ultrasound result raises concerns, such as that you may have liver or colon cancer, you may need a liver or colon biopsy.

Summary

Pancreatic ultrasound can be a useful diagnostic tool if you have signs or symptoms of a disease that may affect the pancreas, or if you have risk factors for pancreatic disease. Ultrasound of the pancreas can be performed as a non-invasive procedure or as an invasive procedure.

Your medical team will work with you to decide what’s best. Depending on the results of the ultrasound of the pancreas, the following stages of examination and treatment will follow.