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Review Article | DOI: https://doi.org/10.31579/2690-4861/246
1Primary health care corporation (PHCC), Qatar.
2Dr. Jamil Altotangi Hospital, MOH, Jordan.
*Corresponding Author: Ahmad Saleh Mufarh Eid, Primary health care corporation (PHCC), Qatar.
Citation: Mufarh Eid AS, Bashar J. Alnajjar, (2026), Abdominal Ultrasound: Imaging Evaluation of the Liver, Gallbladder, Pancreas, and Bowel, J. Biomedical Research and Clinical Reviews, 12(2); DOI:10.31579/2690-4861/246.
Copyright: © 2026, Ahmad Saleh Mufarh Eid. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 20 January 2026 | Accepted: 28 January 2026 | Published: 04 February 2026
Keywords: abdominal ultrasound; hepatobiliary imaging; transducer frequency selection; acoustic windows and patient positioning; bowel ultrasound and gas attenuation
Abdominal ultrasound (AUS) is a non-invasive imaging modality frequently employed to assess conditions of the liver, gallbladder, pancreas, and bowel. It offers a rapid alternative to more extensive imaging protocols in evaluating patients with acute or chronic disease conditions. The speed and accessibility of AUS enable broad adoption in clinical practice. Fundamental ultrasound principles form the basis for reliable liver, gallbladder, pancreas, and bowel assessment. Transducer selection tailored to patient habitus governs image resolution and depth. The liver is optimally evaluated using a 3.0-5.0 MHz curved-array transducer, allowing adequate penetration without undue loss of detail or frame rate. Patient positioning and transducer angling define the fundamental acoustic windows. Bowel assessment is limited due to normal peristalsis and gas-associated attenuation, yet the central abdominal location, targeted imaging between the hepatic flexure and sigmoid colon, and recognition of characteristic echo textural features enhance diagnostic potential.
Abdominal ultrasound facilitates evaluation of the hepatic, biliary, pancreatic, and bowel systems [1]. As a basic technique, it guides the work-up of acute and chronic scenarios. Clinical indications emphasize pain, malignancy and trauma. Limitations center on gas obscuring bowel and hypodense liver lesions [2]. Abdominal ultrasound offers several comparative advantages: it is non-invasive, does not require intravenous contrast, it is readily available, inexpensive and simple to perform [3].
Liver ultrasound has an important role in ongoing patient management, success partly based on straightforward technique [4]. A comprehensive survey of the liver on a single ultrasound study depends upon several technical factors [5]. Each factor therefore merits definition when detailing standard operating procedures [6].
Patients should present fasted to minimize bowel gas. Scanning typically begins in the right upper quadrant with the transducer oriented longitudinally, followed by a transverse orientation of organs from the midline to the right flank [7]. Using aged equipment, measuring liver dimensions with 2-dimensional-echocardiography remains problematic: the tagged end of printed hard-copy images denotes organ dimensionality, and X-ray films of the “m-mode” sonograms remain prevalent [8]. Where either the right lobe of the liver or the gall-bladder remains visible, the distance between those two structures then becomes the dominant examination criterion [7].
1. Overview of Abdominal Ultrasound Principles
Safe, fast, and widely available, ultrasound is the primary tool for assessing the liver, gallbladder, pancreas, and bowel [9]. Insight into hepatic parenchyma, biliary ducts, pancreatic duct, and intestinal loops helps recognize conditions such as cirrhosis, cystic lesions, or intestinal obstruction while guiding decisions on further imaging, intervention, or follow-up [7].
Imaging of the major abdominal organs using ultrasound requires knowledge of instrument selection, scanning techniques, and Doppler utility, supported by an understanding of safe and effective practice [10]. During abdominal ultrasound, transducer choice, positioning and orientation to fluid-filled organs, methods for augmenting bowel aperture and optimizing visualization, and identification of common artifacts remain crucial considerations [11].
Higher-frequency linear arrays (5–12 MHz) provide superior axial and lateral resolution, with lower-frequency convex or sector transducers (1–5 MHz) preferred for wide fields of view [12]. Special-purpose probes (intracavitary/transesophageal) yield access to selective organs [13]. For large adult or obese individuals, sector transducers allow broader access without sacrificing detail [14].
2. Liver Imaging
The normal ultrasonographic anatomy of the liver includes liver parenchyma, portal venous system, hepatic veins and biliary tree [15]. The main portal vein divides in a right and left posterior and anterior branch [16]. The sonographic features of age-related liver anatomical variants and technique-related limitations (e.g. transplant procedure or biliary tree) are summarized. Pathologies impacting liver imaging are classified as diffuse versus focal lesions [17]. Diffuse liver diseases with specific ultrasound hallmarks comprise steatosis, fibrosis, hepatitis, cirrhosis and hemochromatosis [18]. A review of ultrasound findings associated with steatosis, fibrosis and hepatic focal lesions allows for narrowing the differential diagnosis and guiding to further evaluation [19]. Vascular disorders can also be detected by ultrasound: portal vein thrombosis or occlusion and hepatofugal flow. Diffuse abdominal ultrasound diseases are associated with specific ultrasound diagnosis [20]. At least three nominal parameters help reaching a conclusion about diffuse disease (liver size, kidney/liver echogenicity ratio, fibroelastometry) [20]. Various approaches adapt abdominal ultrasound technique acquirement to optimize liver scanning and interpretation [21]. Adequate patient preparation with fasting and standard scans (longitudinal and transverse) assists in identifying the organ and locate lesions. Selection of parenchyma areas, extra-hepatic vessels and biliary branches is useful for obtaining repeatable measurements figuring in a standardized report [22]. Contrast-enhanced ultrasound, perfusion measurements and new imaging strategies can extend scope of liver examination [22].
2.1. Normal Sonographic Anatomy and Variants
Abdominal ultrasound facilitates noninvasive assessment of hepatic, biliary, pancreatic, and bowel systems [23]. Common indications include hepatobiliary disorder, diabetes, abdominal pain, and jaundice [23]. Despite limitations such as operator-dependent quality and reduced visualization in over- or underweight patients, ultrasound offers several advantages over cross-sectional imaging [2]. It rapidly identifies gallstones and small-volume effusions, excludes choledocholithiasis, assesses bowel peristalsis, and interrogates vascular structures [24].
Sonographic evaluation of the liver covers parenchyma, portal venous system, hepatic veins, and biliary tree [8]. Normal anatomic description aids recognition of common pathologies including steatosis, fibrosis, focal lesions, vascular disorders, and diffuse diseases 30. Imaging technique and optimization strategies are also addressed [25].
2.2. Common Pathologies and Sonographic Findings
Abdominal ultrasound represents the first line of investigation for patients with suspected hepatic, biliary, pancreatic, or bowel disorders [26]. Common clinical indications reflect the disease spectrum necessitating examination: hepatitis and hepatitis B virus screening in endemic regions, assessment of liver cirrhosis, jaundice evaluation, acute right upper quadrant pain, hepatocellular carcinoma screening in cirrhotic liver, and traumatic liver injury [8]. Despite liver biopsy, CT, or MR imaging being helpful, ultrasound plays an important role in the follow-up of liver disease and post-treatment evaluation of various lesions [27]. Bowel ultrasound is often the main tool to assess inflammatory bowel disease or abscess [28]. Compared to other imaging techniques, ultrasound is more available, can be performed in bed, requires no radiations, and has a potential cost-saving impact [26]. It can be performed before other imaging, and in many instances, has a better performance than other modalities [29].
2.3. Technique and Optimization
In preparing for an abdominal ultrasound examination, the patient’s abdomen should be free of air and excess fluid [30]. To this end, fasting for eight to twelve hours is usually prescribed [31]. In pediatrics, shorter fasting time is required [31]. Many medications are allowed, except for those that lower peristalsis [8]. The patient is positioned supine, with the right arm raised above the head and the legs in a comfortable position [32]. An additional position in the right lateral decubitus may facilitate gallbladder or kidney assessment [33]. Acoustic windows begin with a longitudinal-entry plane through the epigastrium (liver, portal vein, aorta) selected based on the clinical question [34]. A summary of the examination approach appears with emphasis on pelvic ultrasound [35].
After scanning a basic series of images, supplementary acquisitions proceed according to the established protocol [36]. Routine frontal planes examine the liver (longitudinal sections at right lobe, caudate, and left lobe; transversal sections through aortic bifurcation), gallbladder (longitudinal and transversal), pancreas (longitudinal head-craniocaudal; transversal head and neck), kidneys, and bladder [26]. Targeted acquisitions can include abnormal structures or sightlines from another position [37]. All measurements and Doppler color acquisition take place on the standard images [38]. Color Doppler evaluation should check the main and segmentary hepatic arteries, whereas pulse Doppler may furnish additional information about internal flows [39].
3. Gallbladder Evaluation
Gallbladder sonography evaluates anatomical variants, detects gallstones, sludge, and cystic lesions, and diagnoses cholecystitis or biliary tract obstruction [40]. The gallbladder, a muscular pear-shaped reservoir for bile, can migrate aberrantly, undergo malformations, or develop cysts [40]. Standard scanning planes include longitudinal and transverse views through the organ's body; measurements of length, diameter, wall thickness, and duct caliber can supplement the examination [41].
Acute and chronic cholecystitis arise from obstruction, with acute cholecystitis commonly linked to the cystic duct via gallstones [42]. Diagnostic criteria encompass gallbladder wall thickening exceeding 3mm, pericholecystic fluid, and the sonographic Murphy sign [43]. In acute cases, the gallbladder is typically distended; in chronic cholecystitis, the gallbladder often remains contracted [44]. The differential diagnosis for thickened walls includes primary or metastatic hepatic lesions [45].
3.1. Normal Anatomy and Variants
Abdominal ultrasound is a widely performed non-invasive examination. Ultrasound examination of the liver, gall bladder, pancreas and bowel can be performed under a single examination covering all organs of the upper abdomen [46]. A limited survey of the liver, gall bladder, pancreas and bowel is often requested for screen [47]. It is commonly practiced by ultrasonicates [48]. The safety of abdominal ultrasound has been reviewed. In the study, seventy normal adult subjects aged between eleven to seventy- two years were selected [22]. A total of four hundred and seventy-seven screenings [1]. The liver is examined in subcostal and intercostal views as stated by other authors [49]. Abdominal ultrasound not only indicates cysts, but also indicates some benign causes of hepatic dysfunction [50]. Chronic obstructive jaundice due to extra hepatic obstruction invited due to gall stones, primary sclerosing cholangitis and pancreatic carcinoma are some conditions covered. Such dietary information was often required in the past [50].
The gall bladder is examined in a settled fasting status in the morning hours. The fasting period allows better display of thin wall structure [51]. It also reduces the chance of discovering many abnormalities such as acalculous cholecystitis and decreased gall bladder function [52]. Many other details are covered in the survey such as radiolucent stones, gall bladder dilatation from outflow obstruction, detection of innumerable small stones, abnormality of the aorta and infra renal condition of abdominal aorta [53]. To detect the gall bladder only fasting is sufficient. Gall stone evaluation is different from gall bladder ultrasound [53]. Speculation is dismissed for gall stones [54]. The gall bladder is circumferentially scanned in the intercostal view [55]. Normal transabdominal ultrasound procedure for investigating the gall bladder is described. There are many other stops points and scanning protocols that can be followed [56].
3.2. Acute and Chronic Cholecystitis
Cholecystitis represents a common inflammatory process localized to the gallbladder; with the condition most often being precipitated by the presence of gallstones [6]. The inflammation may be acute or chronic in nature and complicating alterations of the gallbladder wall, surrounding fluid, and parenchymal blood flow develop following a duration of inflammation [5]. Standards for the diagnosis of acute cholecystitis are provided through the Tokyo Guidelines on Acute Cholecystitis [44].
Acute cholecystitis is indicated Sono graphically if at least one of the following findings is present: gallbladder wall thickening of 4 mm or greater, pericholecystic fluid collection, or sonographic Murphy’s sign [57]. Findings supporting the diagnosis of acute cholecystitis but not included in the Tokyo Guidelines comprise gallbladder distention, intramural gas or air-fluid levels characterized as crescent-shaped within the gallbladder, and vascular lesions detected across the gallbladder wall [58]. In acute cholecystitis, gallbladder stones are visualized according to the normal clinical classification system [59].
3.3. Gallstones and Biliary Sludge
Gallstones and biliary sludge are the most common conditions affecting the gallbladder [57]. Biliary sludge consists of a mixture of bile pigments and cholesterol crystals with a defined echogenicity [60]. Gallstones can be differentiated from sludge because they are mobile inside the gallbladder lumen, while sludge does not show mobility [61]. Gallstones can be echogenic, with posterior acoustic shadowing that varies according to the type of stone, or non-echogenic without posterior acoustic shadowing [44]. Both gallstones and biliary sludge are essential to mention if seen during the examination, and the gallbladder should also be checked for collection of a fluid that could be an indicator of a possible aspiration of a bile [62].
3.4. Gallbladder and Biliary Ductal Dilatation
Gallbladder and biliary ductal dilatation detected on ultrasound warrants careful evaluation of both the degree of dilatation and possible obstructive etiologies [62]. Routine guage thresholds define the limits of normality for gallbladder neck (≤ 10 mm) and common bile duct (≤ 7 mm) dimensions [57]. For the latter, the upper threshold of normality has been reported to change with age [63]. Downstream consequences of obstruction, such as gallbladder distension or intrahepatic ductal dilatation, complement the differential diagnosis for extra-, intra-, and pancreatic ductal obstruction [64].
4. Pancreas Imaging
Abdominal ultrasound demonstrates reliable, extensive, and safe capability for assessing the liver, gallbladder, pancreas, and bowel [65]. The liver is evaluated for echogenicity, size, contour, portal vein anatomy, biliary tree, focal lesions, and in some clinical scenarios, perfusion patterns [47]. The gallbladder assessment ranges from an uncomplicated study to establishing acute cholecystitis, identifying the presence of stones and sludge, and investigating dilatation [50]. Pancreatic imaging concentrates on determining the presence of acute or chronic pancreatitis, the visualization of certain masses, and cystic lesions of the pancreas [66]. The bowel assessment focuses on demonstrating the condition of the bowel wall, content (presence of plications) and evaluation of significant packing [49]. Each organ analysis is performed independently, but recognizes the interaction of the organs with afflictions observed in one part altering the other [65].
4.1. Pancreatic Anatomy and Sonographic Windows
The pancreas lies in the retroperitoneum in a transverse position, extending from the second part of the duodenum to the splenic hilum [67]. The normal pancreas demonstrates homogeneous echogenicity, similar to or slightly less than that of the normal liver [68]. The pancreas can be examined using various sonographic windows, including the epigastric, left lateral, and, to a limited degree, suprapubic [69]. The epigastric window is the most useful and is obtained by placing an ultrasound transducer in the midline of the abdomen under the xiphoid process or just above an over-distended urinary bladder [8].
When the pancreas cannot be visualized adequately through these approaches, alternative positions, such as upright or left lateral decubitus, may be beneficial [70]. The anterior wall of the stomach can also be examined to assess whether filling of the organ is appropriate [71]. In the left lateral approach, the left lobe of the liver is visualized, and if it appears smaller than expected, the head of the pancreas should be evaluated for enlargement [72]. The imaging of the pancreas is complemented by the assessment of the splenic artery and vein [73]. A dilated splenic vein in the left lateral position indicates possible pancreatitis [74]. The gallbladder is situated in the gallbladder fossa at the inferior aspect of the liver [74]. The normal gallbladder wall is thin, demonstrating a trilaminar appearance [73]. The gallbladder is usually examined through an epigastric window or an intercostal window [75]. In patients prone to obstructive jaundice, the gallbladder remains distended despite fasting [75].
The gallbladder can be visualized through multiple approaches [76]. In the epigastric or anterior abdominal approach, once the liver has been evaluated through a longitudinal scan with the transducer placed along the line between the xiphoid process and the umbilicus, it is maneuvered laterally towards the right upper quadrant [77]. Holding the transducer at a 45-degree angle permits the gallbladder and liver to be examined in the same setting [78]. For the intercostal approach, the transducer is placed in the right upper quadrant for a longitudinal scan of the right lobe [78]. Ideally, the left lobe of the liver should also be evaluated through the same window to confirm the gallbladder is being assessed, as the gallbladder fossa can be mistaken for a portion of the caudate lobe or a cystic lesion in the medial inferior segment of the right lobe [79]. Scanning through the right kidney and suprarenal glances along the aorta can provide supportive points and alleviate uncertainty regarding the gallbladder location [80]. In patients with acute cholecystitis, the gallbladder wall is enlarged but not always available for assessment [81].
4.2. Acute and Chronic Pancreatitis
Normal pancreatic echogenicity reflects the combined echogenicity of the gland itself and mesenteric fat; isoechoic to slightly hyperechoic compared to liver parenchyma is typical [82]. Variations in echogenicity are related to age, sex, body habitus, and nutritional status; visualizing the gland may be especially challenging in large patients [83]. Scans should ideally be obtained with the patient in the supine or left lateral decubitus position [84]. Multiple windows are available—subxiphoid, right upper quadrant, left upper quadrant, and periumbilical—and manoeuvres such as deep inspiration, splenic flexure compression, and water ingestion can facilitate access [82].
Acute pancreatitis is an inflammatory condition characterized by autodigestion of the pancreas due to inappropriate activation of digestive enzymes [85]. It can be classified as mild, moderate, or severe according to the clinical severity index. Changes can be detected within 24–48 hours in up to 90% of cases, which include: enlargement of the gland, an increase in echogenicity, low-echo peripancreatic fluid along the parietal peritoneum, enlargement of the main pancreatic duct, and complications affecting other abdominal organs [86]. A wide differential diagnosis remains possible, including pancreatic trauma when clinical suspicion is high [87].
Chronic pancreatitis is differentiated from the acute form by the presence of irreversible histological changes [88]. Early-stage chronic pancreatitis may be indistinguishable from mild acute pancreatitis on ultrasound, although approximate staging systems have been established [70]. Changing sonar images of the gland may also yield distinguishing signs [70]. A checklist of imaging characters can aid in formulating differential diagnoses [88].
4.3. Pancreatic Neoplasms and Cystic Lesions
Several neoplasms and cystic lesions of the pancreas have sonographic features that permit a confidence diagnosis or allow selection of appropriate complementary cross-sectional imaging or endoscopic assessment [89]. The most frequent pancreatic entities recognized by ultrasound comprise solid tumours, cystic neoplasms, pseudocysts, and serous cystadenomas [90]. Endoscopic ultrasound examination aids in characterizing solid and cystic pancreatic masses or lesions; cross-sectional imaging assists in evaluating the extent of disease and surgical planning [91]. Knowledge of the common pancreatic variants and pathology and awareness of pitfalls improve diagnostic confidence and accuracy [92].
4.4. Pitfalls and Artifacts in Pancreatic Ultrasound
Despite its established role in non-invasive assessment of the pancreas, ultrasound has certain limitations in visualizing this organ [93]. These limitations include inherent anatomical factors, the presence of bowel gas, and operator dependency [94]. Although some manoeuvres that may improve pancreatic access via the transabdominal route are well-known, they are often poorly applied in practice [93]. Specific factors may further affect the quality of ultrasound evaluation, including insufficient patient history, inconsistency in technique, and failure to recognize the appearance of an abnormal pancreas or related conditions [94]. Pitfalls and artifacts in pancreatic ultrasound may lead to misinterpretation of findings and erroneous diagnosis [94]. Accurate detection and characterization of pancreatic diseases ultimately depend on clear acquisition and analysis of images, along with avoidance of misinterpretation [95].
5. Bowel Assessment in Abdominal Ultrasound
Sonographic evaluation of the bowel includes assessment of the small and large bowel loops, visualizing wall thickness, layering, peristalsis, and adjacent mesenteric interfaces [96]. All systemic organs, including the small and large bowel, may be studied with ultrasound [97]. Several pathologies are demonstrable with ultrasound, including inflammatory, infectious, ischemic, obstructive, and neoplastic conditions [32]. Access to cross-sectional imaging, such as CT or MRI, should be considered when bowel ultrasound does not permit confident diagnosis [98]. Practical tips to optimize scanning and patient-cooperation strategies should be employed when studies are performed [99].
5.1. Sonographic Evaluation of the Small and Large Intestine
The small and large intestine can also be evaluated using abdominal ultrasound [98]. Although the sensitivity of this technique is low, it nevertheless provides some useful information without pre-treatment [100]. The small intestine can be subjected to measurements of wall thickness, peristalsis, and structure of walls [101]. Additionally, the surrounding mesenteric interface can be observed [102]. The large intestine can be assessed in a similar manner, but a volume of fluid is necessary for a proper study [103]. The evaluation of intestinal ultrasound is limited, and in cases of obstruction, CT or MRI are often selected [104].
The analysis concentrates on the pancreas; possible hepatic, biliary, and renal, or extra-abdominal pathologies are noted within the examination [105]. Evaluation of the abdominal organs is carried out according to a systematic approach: specific window techniques and positioning procedures optimize results, and during each step, the entire abdomen is repeatedly reviewed [106].
5.2. Common Bowel Pathologies and Sonographic Features
Abdomen is a common ultrasound examination that includes imaging of the liver, gallbladder, pancreas, bowel, and urinary system [41]. Abdominal ultrasound examinations are requested along with obstetric, gynecological, and vascular examinations [107]. Abdominal ultrasound examinations are crucial for assessing suspected pathology, monitoring the response to treatment, and performing follow-up studies in patients who have undergone surgical treatment [96]. Abdominal ultrasound has an important role in the assessment of infectious diseases, hepato-biliary- pancreatic diseases, and inflammatory bowel disease [32]. The ultrasound assessment of the bowel includes the small bowel, large bowel, and rectum [108]. The ultrasound evaluation of the bowel assesses the bowel wall, diameter of the bowel, peristalsis, motility, abdominal compartment syndrome, wall patterning, and extra intestinal disease [109]. The ultrasound evaluation of the bowel is especially useful for pediatric and obstetric oblique patients [41].
5.3. Limitations and Supplemental Imaging
The sonographic evaluation of the liver, gallbladder, pancreas, and bowel is fundamental yet inherently limited [2]. Abdominal ultrasound is often the first-line modality for assessing biliary tract and pancreatic conditions, capable of distinguishing acute cholecystitis and pancreatitis from alternative diagnoses [109]. Hepatic pathology, while typically not an initial ultrasound target in the face of alternate clinical concerns, is nevertheless encountered in parallel studies, with abnormal findings frequently evident [108]. Key limitations include operator dependency, restricted definition of normality, diminishing sensitivity for disease detection in the presence of abnormalities, and the inability to evaluate certain lesions [110]. Supplementary imaging, particularly computed tomography or magnetic resonance techniques, is appropriate for interrogating suspected pathology, assessing complications, or further clarifying differential considerations [32].
Interpretation of bowel ultrasound is further complicated by inadequate attainment of a full clinical history, ongoing therapy, and the time-consuming nature of the examination within a typically constrained protocol [111]. The small and large bowel are therefore better studied using other modalities when broader anatomical imaging of the renal tract, gallbladder, and pancreas is pursued [112]. The presence of gallstones affecting the cystic duct, a factor of relevance to the clinical inquiry, can also be determined readily via a brief ultrasound evaluation [113].
6. Integration of Findings and Clinical Correlation
The value of abdominal ultrasound is heightened by the ability to correlate findings across hepatic, biliary, pancreatic, and bowel systems and to integrate these observations with the clinical context [32]. Careful consideration of relevant history in relation to the sonographic appearance permits a concise differential diagnosis to be proposed, enabling targeted recommendations for further investigation, additional management steps, or follow-up time frames [114].
In the liver, liver steatosis and gallstones are prevalent findings in individuals with a history of both hepatitis and alcohol consumption [8]. In patients with hepatitis, gallstones may not be readily visible, especially lenticular stones [115]. In such cases, examining bile duct dilatation and associated clinical information can provide significant insights [116]. Both transluminal and non-transluminal approaches can prove valuable for assessing gallbladder disease in the context of hepatitis [117]. For cystic lesions, a list of differential diagnoses can be narrowed down to hydatid cysts, abscesses (bacterial, amebic, or hydatid), pancreas divisum, and choledochal cysts, particularly when sonograms indicate the presence of a normal external envelope [118].
Focal areas of abnormal echogenicity in the liver, whether increased or decreased, warrant attention; key features such as number, size, vascularity, and presence of internal echoes can help differentiate various types of tumours, both benign and malignant [119]. For suspected inflammatory processes within the pancreas, a review of surrounding abdominal structures is advisable [120]. Findings consistent with pancreatitis may still be indicative of biliary obstruction secondary to choledocholithiasis, especially when the patient has a record of biliary colic [121]. Ulcerative colitis can also be indicated through examination of contiguous segments of the colon [121].
Abdominal ultrasound offers a valuable imaging modality for evaluating the liver, gallbladder, pancreas, and bowel. Its clinical applications in these organs are numerous, and the technique can be performed readily using standard equipment. Among available imaging options, ultrasound provides several distinct advantages over other modalities, complementing computed tomography and magnetic resonance imaging. The respective strengths of each imaging technology can be leveraged to enhance patient management 8. The information provided in this chapter facilitates the implementation of comprehensive ultrasound protocols suited to institutional requirements and the specific capabilities of equipment. Future developments in abdominal imaging will include improvements in three-dimensional rendering, evaluation of biliary and vascular flow, and contrast-enhanced ultrasound techniques to extend the examination beyond hepatobiliary structures.
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I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
