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. 04.1}Rosenberg, H K; Markowitz, R I; Kolberg, H; Park, C; Hubbard, A; Bellah, R D (1991). “Normal splenic size in infants and children: sonographic measurements
   “. American Journal of Roentgenology 157 (1): 119–121. doi:10.2214/ajr.157.1.2048509. ISSN 0361-803X. 

Ultrasound examination of the spleen

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Ultrasound of the spleen – is a method that uses an ultrasound signal to examine the spleen.

The spleen – is an organ that performs several important functions in the body. In the spleen, the formation of certain blood cells, as well as the renewal of some of them. In addition, the spleen is also part of the immune system.

Thus, a hematologist (if a blood disease is suspected), a gastroenterologist, a therapist (if an increase in the size of this organ is detected), an allergist-immunologist (if a disease of the immune system is suspected) can give a referral for an ultrasound examination of the spleen ), an infectious disease doctor (if you suspect some infectious diseases, for example: typhoid fever, mononucleosis, etc. ).

What is the diagnostic value of ultrasound examination of the spleen?

Ultrasound can determine:

1. Size of the spleen (increase or decrease in the size of the organ).
2. Organ location
3. Fabric density
4. Presence or absence of pathological inclusions.
5. Spleen capsule integrity
6. Presence or absence of malignant neoplasms of the spleen.
7. Organ blood flow (examination of arteries and veins).
8. Presence or absence of infarction (areas of ischemia and necrosis) of the spleen.

Is it necessary to follow a diet before ultrasound of the spleen?

Due to the fact that the spleen is an organ located in the abdominal cavity, this examination should be performed on an empty stomach.

If the procedure is scheduled for the morning, then you can not take breakfast, and if the procedure is scheduled in the afternoon, the last meal should be no later than 6 hours before the ultrasound examination.

If a person is not on a diet, but is admitted to hospital urgently and needs an ultrasound of the spleen, will they have this scan?

Of course, if there are indications (suspicion of rupture of the spleen capsule, suspicion of intra-abdominal bleeding), an ultrasound examination is mandatory, regardless of whether the patient took food before the examination or not.

How does the examination usually go?

For examination of the spleen, the patient is asked to remove outer clothing to the waist, lie on his back. Sometimes, for a more detailed examination, the patient may be asked to turn on their right side. This is necessary in order to increase the viewing angle of the left hypochondrium, just where the spleen is normally located.

What is the normal size of the spleen?

The normal dimensions of the organ are in the range: length from 11-12 cm, width 6-8 cm, thickness 4-5 cm (in an adult).

Where should the spleen normally be located?

The spleen is normally located in the region of the left hypochondrium between the 9th and 11th ribs. However, there may be pathological options: the spleen may be displaced, a person may have an additional smaller spleen (the so-called splenitis), in addition, in some very rare cases, the spleen may be completely absent (or as a variant of a congenital anomaly of development, or due to surgical removal of the organ in the patient’s history).

Why is such an indicator as the “density” of the spleen tissue examined?

In some diseases (eg, leukemia, mononucleosis), the density of the spleen tissue may be increased. It is for this reason that it is important to examine the density of the fabric in order to understand all the subtleties and nuances.

Why is the integrity of the spleen capsule examined?

Ultrasound can reveal rupture of the spleen capsule, bleeding from the vessels of the spleen, hematoma under the capsule. As a rule, all these conditions are considered urgent and require emergency surgical care. It is for this reason that it is very important to correctly diagnose in time in order to save the patient’s life and prevent further blood loss and hemorrhagic shock.

Is it possible to determine the presence of a spleen tumor by ultrasound?

Yes, thanks to ultrasound diagnostics, tumor-like neoplasms in the spleen tissue (cysts, malignant tumors) can be seen. In addition, a significant diagnostic point is the determination of not only the tumor, its size, but also the presence of blood flow in the tumor tissue (how well the tumor is supplied with blood). To do this, dopplerometry of the vessels of the spleen is used, which makes it possible to assess the speed of blood flow and the presence of pathological vessels in this area.

Why is the examination of the spleen vessels performed?

Ultrasonography provides an opportunity to assess whether there are aneurysms or vascular anomalies. Normally, the diameter of the splenic vein is 5 mm, the splenic artery is 1-2 mm.

Ultrasound is one of the most informative research methods that has many advantages, namely: there is no complicated preparation for the method, it does not harm the patient, the study is available to the patient (if there is a referral, ultrasound can be carried out free of charge according to compulsory medical insurance).

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Ultrasound of the spleen: normal, size of the spleen in children by ultrasound

CONTENTS

1. Where is the spleen located?
2. Enlargement of the spleen in a child
3. Preparation for ultrasound of the spleen
4. Measurements of the spleen by ultrasound in children and adults
5. What is the danger of an enlarged spleen in a child?

Despite the fact that the absence of the spleen in general does not affect the general well-being and a person without a spleen can live in peace, its removal is not a catastrophe for the body. But the spleen is still a very important organ for many reasons – it fights against diseases of the blood and bone marrow, participates in the formation of humoral immunity (when the body’s defense system produces special antibodies that fight infections) and cellular immunity (cellular immunity is responsible for resisting bacterial and viral infections). It is also involved in the metabolism of iron, lipids, proteins and carbohydrates.

Where is the spleen located?

The spleen is located in the region of the left hypochondrium, between the diaphragm and the stomach at the level of the 9th to 11th ribs. Unlike adults, in children the spleen is not fully closed by the ribs and is less protected from external influences (shocks).

Where is the spleen located

The spleen develops throughout life and due to the proportional increase in the size of the spleen during the growth of the child, its shape does not actually change. But sometimes the spleen in both adults and children is enlarged.

Enlargement of the spleen in a child

Ultrasound is considered one of the best methods for diagnosing the condition of the spleen. An enlarged spleen can be detected during an abdominal ultrasound. On palpation, the spleen in children with normal size cannot be detected. It is palpable if it is increased by 1. 5-2 times compared to the age norm. Its increase is called splenomegaly .

Splenomegaly can be detected in any disease that provokes lymphadenopathy – an increase in lymph nodes. But the most common causes of an enlarged spleen are infectious inflammations (especially with typhoid fever, hepatitis, infectious mononucleosis, etc.), oncological, hematological diseases and liver damage. An increase in the organ is observed as a complication of anemia and rickets.

Splenomegaly can often be the only indicator of congenital cytomegalovirus infection in newborns.

Preparing for an Ultrasound of the Spleen

Preparing for an Ultrasound of the Spleen is the same as for a similar examination of the abdomen. Do not eat or drink for 8 hours before the examination. Children, if conditions permit, should refrain from eating and drinking for 3 hours before the study. It is advisable to stop taking foods that promote gas formation 2-3 days before the ultrasound (sweets, legumes, cabbage, wheat bread, muffins, milk, etc. ).

Preparation for ultrasound involves taking enterosorbents such as lactofiltrum, activated charcoal, smecta for several days before it. These drugs are taken one tablet two to three times a day. The intake of enterosorbents is necessary in order to completely avoid gas formation, which can greatly complicate this study.

Ultrasound of the spleen

The ultrasound of the spleen itself lasts five to ten minutes. During ultrasound, the subject does not feel any discomfort, and there are no contraindications to ultrasound examination. First, the ultrasound doctor scans the organ in a position where the subject is lying on his back, and then lying on his right side.

Ultrasound measurements of the spleen in children and adults

It is desirable that the spleen be scanned in three linear dimensions, which is considered more accurate than two linear dimensions. Demand from the sonographer in the digital data scanning protocol, and not just a description – “enlarged” or “not enlarged”, this will allow you to observe changes in the size of this organ in dynamics.

In ultrasound examination, the size of the spleen in children directly depends not only on age, but also on its height.

Dimensions of the spleen and diameter of the splenic vein according to ultrasound, depending on the height of the child

Height, cm	Length (mm)	Width (mm)	Thickness (mm)	Splenic vein (mm)
60-69	54.60 ± 6.77	26.20 ± 3.56	24.33 ±3.79	3.27 ± 0, 64
70-79	62.07 ± 5.79	28.36 ± 3.86	25.00 ± 3.46	3.02 ± 0.39
80-89	67.06 ± 4.97	31.18 ±3.50	27.63 ± 4.0 0	3.06 ± 0 .42
90-99	70.85 ±7.10	34.21 ±3.80	33.00 ± 4.45	3.47 ± 0.52
100 -109	73.14 ±7.20	36.25 ± 3.67	32. 78 ± 3.76	3.96 ± 0.76
110-119	76.90 ±6.12	37.66 ± 3.85	35.09 ±5.19	4.22 ± 0.60
120-129	83.97 ± 7.44 .92	35.67 ± 5 .03	4.62 ± 0.75
130-139	88.86 ± 9.30	41.86 ±5.81	38, 80 ± 6.02	4.92 ± 0.53
140-149	92.20 ±9.21	44.98 ± 5.49	40.34 ± 4.99	5.40 ± 0.68
150 -159	98.11 ±9.58	46.50 ±5.17	42.46 ± 5.49	5.46 ± 0.82
160-169 901 76	102.44 ±8, 62	48.96 ± 5.59	45.52 ± 5.35	5.76 ±0.91
more 9.25	51.60 ±6 ,81	46.03 ± 5.29	6.10 ±0.68

Why is an enlarged spleen in a child dangerous?

Enlargement of the spleen is not an independent disease, but the result of a number of diseases that are not diagnosed by ultrasound and require consultation not only of a pediatrician, but also of a number of other specialists.