Acute kidney injury (AKI) is responsible for a 20-30% in-patient mortality rate and it is estimated that 15% of adults admitted to hospital develop AKI. The mortality rate varies greatly depending on the severity, setting, and many patient-related factors but it is a KILLER. Early detection is therefore essential. Causes of AKI can be pre-renal, renal, or post renal and an ultrasound scan is a useful tool in the armoury for assessment. Ultrasound should be used to differentiate between renal and post-renal causes, which incudes renal obstruction. This presentation investigates AKI and the role of ultrasound, and explores the causes of AKI that can be detected early to help manage this killer condition.

Introduction: Chronic Kidney Disease (CKD) shows alterations in renal sinus fat echogenicity and kidney stiffness.
Methods: Sequoia ultrasound transducer C 5-1 used for sonoelastography and fat sinus percentage on 824 participants (412 cases, 412 controls).
Results: Mean ± SD age: 58.87 ± 15.39 and 53.71 ± 18.25 years for the cases and control participants. 80.6% and 19.4% male: female for each group. 61.3% and 67.7% of the participants have diabetes and hypertension in cases. There were no comorbidities in the control group. Renal cortex size was smaller in cases (0.54 ± 0.16 cm) than in controls (10.19 ± 1.22 cm) and conversely, renal sinus size was larger in cases (2.77 ± 0.53 cm) vs. controls (19.58 ± 2.93 cm). This indicated cortical thinning and sinus expansion in cases. In cases, compared to controls, kidneys were smaller (8.56 ± 2.27 cm vs. 97 ± 8.13 cm). Cases showed grade 2 (74.2%), grade 1 (9.7%) and grade 3 (16.1%) echogenicity, compared to normal echogenicity in controls (P-value < 0.001). Resistive index was higher in cases (0.81 ± 0.08) than controls (0.74 ± 0.01), suggesting increased resistance. Cortical elasticity was lower in cases (0.78 ± 0.17) than controls (1.83 ± 0.25), renal sinus elasticity was higher in cases (1.83 ± 0.24) than controls (0.78 ± 0.11). Cases show higher renal sinus fat percentage (18.48 ± 5.28% vs. 5.45 ± 1.61%) and greater brightness (grade 2, 64.5%).
Conclusion: Quantitative measures of kidney stiffness and sinus fat in showed significant differences between cases and controls.

Introduction: Ultrasound survey of the abdomen is a powerful tool for detecting free fluid in trauma and non-trauma settings. Its accuracy relies heavily on scanning technique. A common and avoidable error is keeping the transducer fixed in one position during assessment. This talk will highlight why systematic probe movement and landmark identification are essential for diagnostic accuracy. Good ultrasound practice means “don’t be a plonker”.
Method: Rather than “probe parking”, this talk will provide a systematic approach to assessing the RUQ, LUQ and pelvis including two illustrative case studies demonstrating clinically significant abdominal pathology. Key anatomical landmarks will be identified, and the inclusion of the symphysis pubis as a vital landmark for assessment of fluid in the pelvis will be discussed.
Results: A systemic sweep rather than static imaging improves detection of gravity-dependent fluid collections and may detect other significant abdominal pathologies.
Conclusion: Abdominal survey for free fluid is a dynamic examination. A fixed probe approach is inconsistent with best practice and increases the risk of missed pathology. Systematic and multiwindow scanning is essential for accurate and clinically meaningful assessments.
Take Home Message: Don’t be a plonker! Move the probe, scan systematically and include essential anatomical landmarks.

Learn a clear, step by step approach to scanning renal transplants, from image acquisition to Doppler optimisation. The presentation will also unpack the key complications in new and long standing grafts, with the imaging clues you cannot miss.

Introduction:Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly prescribed for diabetes management and weight loss. These agents delay gastric emptying and are now commonly encountered in routine abdominal ultrasound examinations. Traditionally ‘Upper Abdomen’ ultrasound reports mention stomach and contents only as a limitation. Is it time we updated our protocols and actually report ON the stomach, rather than it simply being a cause of imaging limitations? Optimal fasting is imperative for upper abdominal ultrasound for visualisation of the liver, pancreas, biliary system. Delayed gastric emptying associated with GLP-1 receptor agonists results in gastric distension and increased bowel gas, compromising ultrasound visualisation. Historically, stomach contents have been reported as a limitation to image quality rather than a clinically relevant finding. Sonographers can learn to evaluate and diagnose stomach and gut related information and incorporate stomach assessment into routine protocols.
Methods: This presentation discusses the mechanisms of GLP-1 receptor agonists, their utility and complications. An overview of stomach and contents evaluation with ultrasound and discussion of how ultrasound is increasingly being utilised perioperatively to evaluate aspiration risk.
Conclusion: As GLP-1 receptor agonist use becomes more prevalent, traditional fasting protocols and reporting practices may require revision. Recognising gastric contents as a diagnostic observation rather than solely a technical limitation represents an important evolution in abdominal ultrasound practice.
Take-Home Message: Sonographers are well positioned to assess gastric contents, contribute diagnostic insight, and communicate findings within multidisciplinary teams. Updating protocols and reports to positively document stomach contents may improve examination quality, clinical relevance, and patient care.