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How big is a normal spleen: Determination of normal dimension of the spleen by ultrasound in an endemic tropical environment

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]

90% confidence interval of maximum spleen length by abdominal ultrasonography by height of the person
HeightSpleen length
WomenMen
155 – 159 cm6.4 – 12 cm
160 – 164 cm7.4 – 12.2 cm8.9 – 11.3 cm
165 – 169 cm7.5 – 11.9 cm8.5 – 12.5 cm
170 – 174 cm8.3 – 13.0 cm8.6 – 13.1 cm
175 – 179 cm8.1 – 12.3 cm8.6 – 13.4 cm
180 – 184 cm9.3 – 13.4 cm
185 – 189 cm9.3 – 13.6 cm
190 – 194 cm9.7 – 14.3 cm
195 – 199 cm10.2 – 14.4 cm
AgeCutoff[4]
3 months6. 0 cm
6 months6.5 cm
12 months7.0 cm
2 years8.0 cm
4 years9.0
6 years9.5 cm
8 years10.0 cm
10 years11.0 cm
12 years11.5 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.