How does spleen size vary with age, gender, and body size. What are the normal dimensions of the spleen as measured by ultrasound. When should an enlarged spleen be a cause for concern.

The Crucial Role of the Spleen in Human Health

The spleen, a small but vital organ nestled behind the stomach and beneath the diaphragm, plays a significant role in maintaining our health. This organ acts as a sophisticated filter for our blood, performing several critical functions:

• Filtering out old, damaged, or abnormal red blood cells
• Removing certain bacteria and viruses from the bloodstream
• Producing lymphocytes to combat infections
• Supporting the body’s immune system

Unlike many other organs, the spleen’s size can change throughout a person’s lifetime, often in response to illness or injury. Understanding what constitutes a normal spleen size is crucial for healthcare professionals to diagnose potential health issues accurately.

Factors Influencing Normal Spleen Size

Several factors can influence the size of a healthy spleen:

1. Age
2. Gender
3. Height
4. Weight
5. Overall health status

Research has shown that women typically have smaller spleens than men, and taller individuals tend to have larger spleens compared to shorter people. These variations highlight the importance of considering individual characteristics when assessing spleen size.

How does age affect spleen size?

The spleen grows with age during childhood and adolescence, reaching its maximum size in adulthood. After that, it tends to shrink slightly with each passing decade. This natural progression emphasizes the need for age-specific reference ranges when evaluating spleen dimensions.

Normal Spleen Dimensions: What the Research Says

While individual variation is common, general guidelines for normal adult spleen dimensions are:

• Length: approximately 5 inches (12.7 cm)
• Width: about 3 inches (7.6 cm)
• Thickness: around 1.5 inches (3.8 cm)
• Weight: approximately 6 ounces (170 grams)

However, these figures should be considered as averages rather than strict cutoffs. Medical professionals often use more specific criteria based on ultrasound measurements to determine whether a spleen is enlarged.

What are the upper limits of normal spleen length by age?

Research published in the American Journal of Roentgenology provides guidance on the maximum normal spleen length for children up to 15 years old. These values are particularly useful for pediatric assessments:

• Newborns: up to 6 cm
• 3 months: up to 6.5 cm
• 6 months: up to 7 cm
• 12 months: up to 8 cm
• 2-4 years: up to 9 cm
• 6-8 years: up to 10 cm
• 10-15 years: up to 11 cm

It’s important to note that these figures represent upper limits, and many healthy children will have spleens smaller than these dimensions.

Ultrasound: The Gold Standard for Spleen Measurement

Ultrasound has become the preferred method for evaluating spleen size due to its accuracy, safety, and ease of use. This non-invasive imaging technique offers several advantages:

• No radiation exposure
• Real-time imaging
• Cost-effective
• Widely available
• Can detect other abdominal abnormalities

How is an ultrasound of the spleen performed?

During a spleen ultrasound, a technician applies a special gel to the patient’s abdomen and uses a handheld device called a transducer to send sound waves into the body. These waves bounce off internal structures, creating detailed images on a computer screen. The technician can then measure the spleen’s length, width, and thickness with high precision.

Interpreting Spleen Measurements: When to Be Concerned

While slight variations in spleen size are normal, significant enlargement (splenomegaly) can indicate underlying health issues. Medical professionals often use the following guidelines when interpreting spleen measurements:

• Normal: maximum length less than 11 cm
• Moderate splenomegaly: length between 11-20 cm
• Severe splenomegaly: length exceeding 20 cm

It’s crucial to remember that these measurements should always be interpreted in the context of the patient’s overall health, symptoms, and other diagnostic tests.

What conditions can cause an enlarged spleen?

An enlarged spleen can be a sign of various underlying conditions, including:

• Viral infections (e.g., mononucleosis)
• Bacterial infections (e.g., syphilis)
• Blood disorders
• Liver disease
• Certain cancers
• Autoimmune disorders

If splenomegaly is detected, further diagnostic tests may be necessary to determine the root cause and develop an appropriate treatment plan.

Beyond Size: Other Spleen Abnormalities Detectable by Ultrasound

While size is a crucial factor in assessing spleen health, ultrasound can reveal other important information about the organ’s condition. Radiologists and sonographers look for various characteristics during a spleen examination:

• Echotexture: The spleen should have a uniform, granular appearance
• Contour: A healthy spleen has smooth, well-defined borders
• Focal lesions: Masses, cysts, or other abnormal growths
• Vascular patterns: Abnormal blood flow can indicate various conditions

What are some common focal changes in the spleen?

Ultrasound can detect several types of focal changes in the spleen, including:

• Cysts: Fluid-filled sacs that can be simple or complex
• Hemangiomas: Benign vascular tumors
• Abscesses: Pockets of infection within the spleen
• Infarcts: Areas of tissue death due to reduced blood supply
• Metastases: Cancerous growths that have spread from other parts of the body

The presence of these focal changes may require further investigation or monitoring, depending on their nature and the patient’s clinical presentation.

The Importance of Comprehensive Abdominal Ultrasound

While spleen assessment is crucial, it’s often part of a more comprehensive abdominal ultrasound examination. This broader approach allows healthcare providers to evaluate multiple organs simultaneously, potentially uncovering related issues or alternative explanations for a patient’s symptoms.

What other conditions can be detected during an abdominal ultrasound?

A thorough abdominal ultrasound can reveal various conditions, including:

• Liver abnormalities (e.g., fatty liver disease, cirrhosis)
• Kidney stones or cysts
• Gallbladder problems (e.g., gallstones, cholecystitis)
• Pancreatic issues
• Abdominal aortic aneurysms
• Tumors or suspicious growths in any abdominal organ

This comprehensive approach ensures that potential health issues are not overlooked and allows for a more accurate diagnosis and treatment plan.

Managing Spleen Abnormalities: From Monitoring to Treatment

When spleen abnormalities are detected, the appropriate course of action depends on various factors, including the nature and severity of the issue, underlying causes, and the patient’s overall health. Management strategies may include:

1. Watchful waiting: Regular monitoring for mild enlargement or benign focal changes
2. Treating underlying conditions: Addressing infections, blood disorders, or other causes of splenomegaly
3. Medication: Managing symptoms or targeting specific health issues
4. Lifestyle modifications: Avoiding contact sports or activities with a high risk of abdominal injury
5. Surgery: In severe cases, partial or complete removal of the spleen (splenectomy) may be necessary

What precautions should be taken after spleen removal?

If splenectomy is required, patients need to take certain precautions to compensate for the loss of this important immune organ:

• Staying up-to-date with vaccinations, especially against encapsulated bacteria
• Taking prophylactic antibiotics as recommended by healthcare providers
• Practicing good hygiene to reduce the risk of infections
• Seeking prompt medical attention for any signs of infection
• Informing all healthcare providers about their splenectomy status

With proper care and vigilance, most people can lead normal, healthy lives even after spleen removal.

The Future of Spleen Assessment: Emerging Technologies and Techniques

While ultrasound remains the gold standard for spleen evaluation, ongoing research and technological advancements are expanding our capabilities in this area. Some promising developments include:

• 3D ultrasound: Providing more accurate volume measurements and better visualization of complex structures
• Contrast-enhanced ultrasound: Improving detection and characterization of focal lesions
• Elastography: Assessing spleen stiffness, which can be an indicator of various diseases
• Artificial intelligence: Enhancing image analysis and potentially automating certain aspects of spleen assessment

How might these advancements improve spleen diagnostics?

These emerging technologies have the potential to:

• Increase the accuracy of size and volume measurements
• Improve the detection and characterization of subtle abnormalities
• Provide additional functional information about the spleen
• Reduce the need for more invasive diagnostic procedures
• Enhance our understanding of spleen physiology and pathology

As these techniques continue to evolve, they may lead to earlier detection of spleen-related issues and more personalized treatment approaches.

Understanding normal spleen size and the factors that influence it is crucial for accurate diagnosis and treatment of various health conditions. Ultrasound technology plays a vital role in assessing spleen dimensions and detecting abnormalities. As our knowledge and diagnostic capabilities continue to advance, we can expect even more precise and personalized approaches to spleen health management in the future.

Normal Spleen Size Depends on Weight and Gender

Overview

Your spleen is a small but hard-working organ hidden behind your stomach and under your diaphragm. It acts as a filter for your blood. Old, damaged, or abnormal red blood cells are caught in a maze of narrow tunnels within the spleen. Healthy red blood cells easily pass through the spleen and continue to circulate in your bloodstream.

The spleen can also filter out certain bacteria or viruses from your blood in support of the body’s immune system. When a disease-causing microorganism enters the bloodstream, your spleen and lymph nodes produce lymphocytes, a type of white blood cell capable of making antibodies to fight infections.

Unlike most other organs in your body, your spleen changes in size throughout your life — usually in response to illness or injury. A viral infection, such as mononucleosis, or a bacterial infection, such as syphilis, are among the conditions that can lead to an enlarged spleen.

The size of a normal, healthy spleen can vary considerably from person to person. Your sex and height can also affect its size. In general, an adult spleen is about 5 inches long, 3 inches wide, 1.5 inches thick, and weighs about 6 ounces.

Women tend to have smaller spleens than men, and taller people tend to have larger spleens than shorter people. In a study in the journal Radiology, researchers suggested that aside from men generally being taller than women, men also typically have greater red cell mass than women.

Your spleen, like the rest of your body, grows with age. Once you reach adulthood, however, your spleen tends to shrink slightly with each passing decade. The following is a list of the upper limit of normal spleen length by age up to 15 years. For boys and girls, there is relatively little difference in size, according to a study published in the American Journal of Roentgenology. The average spleen length by age was up to:

During a physical examination, your doctor can usually tell if your spleen is enlarged. A blood test to check your levels of red blood cells, white blood cells, and platelets may also be ordered to help diagnose the cause of a spleen enlargement.

Imaging tests, including ultrasound, help measure the size of your spleen and whether it’s crowding your other organs.

An abdominal ultrasound is often preferred for evaluating the spleen because it’s easy to do and doesn’t require any radiation. Ultrasound uses sound waves to create images of inside the body on a computer screen. An ultrasound “wand” is rubbed on the outside of the belly, which is coated with a special gel. This gel helps transmit the sound waves through the skin and to the parts inside the body.

Ultrasound can usually measure the length of the spleen along a center line (axis) accurately. It can also measure the width and thickness of the spleen, which can typically tell the doctor whether the organ is abnormally large or small. In most cases, however, the concern is about an enlarged spleen.

An abdominal ultrasound can help detect other conditions, too. Some of them include:

• abnormal liver function
• kidney stones
• gallstones
• enlargement of other organs, such as the liver or gallbladder
• abdominal aortic aneurysm (bulge in the main artery that supplies blood to most of the body)
• tumors or other suspicious growths anywhere in the abdominal area

Slight variances in spleen size are common and not a cause for concern. However, if you suspect your spleen is enlarged or you’re having any organ-related problems, see a doctor soon. If an infection is causing this temporary enlargement of the spleen, the sooner you get it diagnosed and treated, the better.

Treating the underlying cause of your spleen growth will usually cause it to return to a normal, healthy size. In very serious cases of spleen dysfunction, the organ can be removed. You will be at greater risk for infections, but that will only mean it’s even more important to keep up to date with vaccinations and other preventive steps, such as washing your hands thoroughly and regularly or avoiding people who may have a contagious infection.

Ultrasonography of the spleen – radlines.org

Author:
Mikael Häggström ^{[notes 1]}

Contents

• 1 Planning
  • 1.1 Indication
• 2 Evaluation
  • 2.1 Size
  • 2.2 Focal changes
• 3 Report
• 4 Notes
• 5 References

Planning

Indication

Ultrasonography of the spleen is included as a general screening of the upper abdomen, or when specifically requested in the referral.

Evaluation

Size

Maximum length of spleen on abdominal ultrasonography.

A measurement of spleen size is a standard procedure as part of a liver exam, since splenomegaly is a sign of portal hypertension.

Suggested cutoffs are:^[1][2]

• Normal (not splenomegaly): the maximum length is less than 11 cm
• Moderate splenomegaly: the maximum length is between 11–20 cm
• Severe splenomegaly: the maximum length is greater than 20 cm

90% confidence intervals of maximum lengths in the normal population have lower limits between 6. 4 cm (in short women) and 10.2 cm (in tall men), and upper limits between 12.0 and 14.4 cm (respectively):^[3]

Age	Cutoff[4]
3 months	6. 0 cm
6 months	6.5 cm
12 months	7.0 cm
2 years	8.0 cm
4 years	9.0
6 years	9.5 cm
8 years	10.0 cm
10 years	11.0 cm
12 years	11.5 cm
15 years	12.0 cm for girls 13.0 cm for boys

For children, the cutoffs for splenomegaly are given in this table, when measuring the greatest length of the spleen between its dome and its tip, in the coronal plane through its hilum while breathing quietly.^[4]

Focal changes

If the referral mentions the spleen, it is generally appropriate to scan the volume of it for any focal changes, mainly cysts or tumors.

Report

• Even absence of enlargement. If enlarged, state both grade (such as moderate) and maximum length in a number
• If checked, even absence of focal changes.

See also: General notes on reporting

Notes

1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

1. ↑ Neetu Radhakrishnan. Splenomegaly. Medscape. Updated Apr. 2012 (referring the classification system to Poulin et al.
2. ↑ Page 1964 in: Florian Lang (2009). Encyclopedia of Molecular Mechanisms of Disease
   . Springer Science & Business Media. ISBN 9783540671367. 
3. ↑ Chow, Kai Uwe; Luxembourg, Beate; Seifried, Erhard; Bonig, Halvard (2016). “Spleen Size Is Significantly Influenced by Body Height and Sex: Establishment of Normal Values for Spleen Size at US with a Cohort of 1200 Healthy Individuals
   “. Radiology 279 (1): 306–313. doi:10.1148/radiol.2015150887. ISSN 0033-8419. 
4. ↑ ^4.