Abdomen Reference Suite

AbdomenSuite is a 10-panel abdominal ultrasound calculator and decision hub — measurements, normal ranges, and evidence-based thresholds for biliary, pancreas, spleen, kidneys, Bosniak cysts, aorta/AAA, mesenteric & renal Doppler, IVC/portal/TIPS, retroperitoneum & wall, plus a one-page Normal Sizes reference sheet. Focal liver-lesion characterization lives in the separate Liver RATS tool.

1 Pick a module

Tabs stay visible as you scroll; the active tab always has neighbours showing on both sides so you never lose place.

2 Enter measurements

Fields are labelled with normal ranges. Quick mode shows just the core inputs; Explore adds age adjustment, gender, and advanced fields.

3 Read the verdict + copy the report

Every module outputs a guideline-referenced decision (AIUM, SVS 2018, Bosniak 2019, AAST) and a one-click report string for the worksheet.

4 Lost? Open the Normal Sizes tab

A read-only one-page reference of every threshold in the suite — use it during scanning when you need a fast lookup.

Gallbladder

GB length cm · normal 7–10

GB AP cm · normal ≤ 4

GB wall mm · normal ≤ 3 fasting

Fasting ≥ 6 h?

Common bile duct

CBD mm · inner-to-inner

Patient age yr

Post-cholecystectomy?

Age rule: +1 mm per decade over 60 (so 70 yr → ≤ 7 mm, 80 yr → ≤ 8 mm). Post-cholecystectomy upper limit ≤ 10 mm. Intrahepatic ducts should not be visible (< 2 mm).

Gallbladder polyp explore

Polyp size mm · longest dim

Sessile?

PSC / Indian ethnicity / age > 50?

Cholecystitis features explore

Sonographic Murphy sign positive probe pressure directly over GB reproduces pain Pericholecystic fluid crescent of fluid alongside GB wall Impacted stone in neck / cystic duct Intramural gas (emphysematous cholecystitis)

Biliary verdict

Enter GB and CBD measurements to see decision

GB size—

Wall—

CBD (age-adjusted cutoff)—

Polyp risk—

Cholecystitis features—

AIUM / Bosniak / SVS: module uses AIUM thresholds for GB wall (≤ 3 mm) and CBD (≤ 6 mm + age rule). Polyp risk follows ESGAR/EAES 2022 consensus.

Gland segments

Head AP mm · normal 19–25

Body AP mm · normal 15–20

Tail AP mm · normal 20–25

Main pancreatic duct (Wirsung)

PD body mm · normal ≤ 2

PD head mm · normal ≤ 3

Age yr

Double-duct sign CBD + PD both dilated → suspect head mass / adenocarcinoma

Age rule: +1 mm per decade over age 70 (80 yr → PD body ≤ 3 mm, head ≤ 4 mm). "Chain of lakes" suggests chronic pancreatitis.

Cystic lesion explore

Largest cyst cm

Morphology

Mural nodule / symptomatic?

Pancreas verdict

Enter measurements to see decision

Gland size (H/B/T)—

Wirsung duct (age-adjusted)—

Cystic lesion—

Rule of thumb: PD body > 2 mm (or age-adjusted cutoff) with parenchymal atrophy = chronic pancreatitis pattern. Double-duct sign → CT/MRCP + oncology.

Dimensions

Length (CC) cm · < 13

Width cm · < 7

Depth cm · < 5

Splenic index = L × W × D (cm³); normal < 480 cm³. Massive splenomegaly > 20 cm (extends across midline / crosses aorta).

Trauma grading (AAST) explore

Laceration depth cm

Subcapsular haematoma % surface

Hilar vascular injury / devascularization?

Spleen verdict

Enter measurements to see decision

Size—

Splenic index—

AAST grade—

Length & cortex

Right length cm · 9–12

Left length cm · 9–12

Cortical thickness mm · > 10 normal

Size discrepancy > 2 cm between kidneys warrants investigation. Cortex < 8 mm suggests chronic disease; < 5 mm concerning for cortical loss.

Hydronephrosis

Grade

Caliectasis present Cortical thinning (< 5 mm)

Doppler (transplant / stenosis) explore

Renal artery PSV cm/s

Aortic PSV cm/s (for RAR)

Intrarenal RI (0.50–0.70)

Tardus-parvus waveform distal delayed upstroke + blunted peak → proximal stenosis

Kidney verdict

Enter lengths to see decision

Size (R / L)—

Cortex—

Hydronephrosis—

Doppler—

RAS criteria: main renal PSV ≥ 200 cm/s OR renal-aortic ratio (RAR) > 3.5 = ≥ 60% stenosis. Tardus-parvus distal = proximal / ostial stenosis or dissection.

Features

Cyst diameter cm

Wall thickness mm

Few thin septa (≤ 2 mm) Thick / nodular septa (> 2 mm) or irregular Fine / thin calcifications Thick, chunky, nodular calcifications Hyperdense (haemorrhagic / proteinaceous) content Enhancing solid component / mural nodule Anechoic + imperceptible wall + posterior enhancement

Bosniak verdict

Select features to see classification

Category—

Malignant risk—

Recommendation—

Bosniak 2019 is CT/MR-defined; ultrasound can screen and triage but complex features (III/IV) require contrast CT/MRI for confirmation.

Measurement

Max AP diameter cm · include thrombus

Method

Patient sex

Segment

Prior diameter (optional) cm

Interval months

AAA = ≥ 3.0 cm (outer wall to outer wall). LELE runs ~2–4 mm smaller than OTO — stay consistent across serial scans and document the method used.

Iliac extension explore

CIA diameter cm · < 1.5

EIA diameter cm · < 1.2

IIA diameter cm · < 1.5

EVAR eligibility (anatomic) explore

Infrarenal neck ≥ 10–15 mm long Neck angulation ≤ 60° Iliac access vessels ≥ 7 mm

Aortic verdict

Enter diameter to see decision

Diameter (method)—

SVS 2018 surveillance—

Annual rupture risk—

Growth vs prior—

Iliac—

EVAR anatomy—

Velocities

Celiac PSV cm/s · < 200

SMA PSV cm/s · < 275

SMA EDV cm/s · < 100

Renal artery PSV cm/s · < 200

Aortic PSV cm/s (for RAR)

Fasting state

Signs explore

MALS sign celiac PSV drops > 30% on deep inspiration → median-arcuate ligament compression Tardus-parvus distal to suspected stenosis Turbulent / reversed post-stenotic flow

Doppler verdict

Enter velocities to see decision

Celiac—

SMA—

Renal / RAR—

Celiac ≥ 200 cm/s or SMA ≥ 275 cm/s = ≥ 70% stenosis. SMA EDV > 100 cm/s suggests high-grade. Renal PSV ≥ 200 or RAR > 3.5 = ≥ 60% RAS. Post-prandial raises SMA velocities — quote fasting values.

IVC / CVP estimation

IVC max mm · 1–2 cm below HV confluence

IVC min mm · on sniff

Collapsibility % (auto)

AIUM / ASE: threshold at 21 mm & 50% collapse. < 21 + > 50% → RAP 0–5. > 21 + < 50% → RAP 15+. Megacava > 28 mm = high IVC-filter migration risk.

Portal vein

PV diameter mm · < 13

PV velocity cm/s · 20–40

PV flow direction

Recanalized umbilical vein ≥ 3 mm with flow Splenomegaly > 13 cm Ascites present

TIPS surveillance explore

TIPS PSV cm/s · 90–190 normal

Prior TIPS PSV cm/s

Hemodynamic verdict

Enter IVC or portal data to see decision

IVC size / collapse—

Estimated RAP—

Portal HTN features—

TIPS—

Adrenal & nodes

Adrenal length cm · 3–6

Limb thickness mm · 3–6

Retroperitoneal node (short axis) mm · < 10

Abdominal wall

Rectus diastasis at rest cm · < 2

Rectus diastasis Valsalva cm · < 3.5

Hernia defect width cm

Ascites (4-quadrant depth) explore

RUQ cm

LUQ cm

RLQ cm

LLQ cm

Retro / wall verdict

Enter measurements to see decision

Adrenal / nodes—

Rectus diastasis—

Hernia—

Ascites—

Biliary

Parameter	Normal
GB length	7–10 cm
GB AP	≤ 4 cm
GB wall (fasting)	≤ 3 mm
CBD (young adult)	≤ 6 mm
CBD age rule	+1 mm / decade > 60
CBD post-chole	≤ 10 mm
Polyp minimal risk	< 6 mm
Polyp low risk	6–9 mm
Polyp moderate risk	10–17 mm
Polyp high risk	≥ 18 mm

Pancreas

Parameter	Normal
Head AP	19–25 mm
Body AP	15–20 mm
Tail AP	20–25 mm
PD body	≤ 2 mm
PD head	≤ 3 mm
PD age rule	+1 mm / decade > 70
Pseudocyst — observe	< 2 cm
Pseudocyst — FU	2–6 cm
Pseudocyst — drain	≥ 6 cm / symptomatic

Spleen

Parameter	Normal
Length (CC)	< 13 cm
Width	< 7 cm
Depth	< 5 cm
Splenic index (L×W×D)	< 480 cm³
Splenomegaly	> 13 cm
Massive	> 20 cm
AAST I / II–III / IV / V	<1 / <5 / >5 / hilar

Kidneys

Parameter	Normal
Length (pole-pole)	9–12 cm
Width	4–5 cm
AP thickness	3–4 cm
Cortical thickness	> 10 mm normal
Inter-renal difference	< 2 cm
Intrarenal RI	≤ 0.70
Bladder wall (distended)	< 3 mm

Bosniak 2019

Category	Malignant
I — simple	~0%
II — minimally complex	~0%
IIF — follow-up	~5%
III — indeterminate	~50%
IV — solid / nodular	~90%

Aorta / AAA (SVS 2018)

Size	Surveillance
Normal infrarenal	< 2.0 cm
AAA defined	≥ 3.0 cm
3.0–3.9 cm	Every 3 yr
4.0–4.9 cm	Every 12 mo
5.0–5.4 cm	Every 6 mo
Repair M / F	≥ 5.5 / ≥ 5.0 cm
Rapid growth	> 0.5 / 6 mo
CIA / EIA / IIA	< 1.5 / 1.2 / 1.5 cm

Doppler thresholds

Vessel	Stenosis
Celiac PSV	≥ 200 cm/s
SMA PSV	≥ 275 cm/s
SMA EDV	> 100 cm/s
Renal PSV	≥ 200 cm/s
RAR (renal/aortic)	> 3.5
TIPS normal	90–190 cm/s
TIPS stenosis	≥ 250 or Δ > 50

IVC / Portal

Parameter	Normal
IVC diameter	≤ 21 mm
Megacava	> 28 mm
Collapsibility (sniff)	> 50%
Portal vein	< 13 mm
PV velocity	20–40 cm/s
Splenic vein	< 13 mm
SMV	< 10 mm
Hepatic veins	< 10 mm

Retroperitoneum / Wall

Parameter	Normal
Adrenal length	3–6 cm
Adrenal limb	3–6 mm
Retroperitoneal node	< 10 mm short axis
Rectus diastasis (rest)	< 2 cm
Rectus diastasis (Valsalva)	< 3.5 cm
Ascites trivial/mild/mod/severe	<1 / 1–2 / 2–3 / >3 cm