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Splenic size: Normal Spleen Size Depends on Weight and Gender

Normal Spleen Size Depends on Weight and Gender


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

Mikael Häggström [notes 1]


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



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



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
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
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.


  • 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


  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.


  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. 04.1Rosenberg, 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.

dimensions, norm for ultrasound in adults and children, preparation for ultrasound

The spleen, despite its small size and auxiliary functions, is a very important organ. And although the removal of the spleen does not entail serious consequences, this organ is a faithful assistant in the formation of immunity, metabolism in the body, as well as in filtering blood from damaged corpuscles and foreign substances. Therefore, timely examination of the organ helps to prevent its loss, and possibly surgery.

Ultrasound of the spleen in adults and children

Ultrasound examination is based on the action of ultrasonic waves, which are completely harmless. The efficiency is somewhat lower compared to MRI, CT and others, but there are no restrictions. There are no contraindications to ultrasound for either children or adults. Ultrasound of the spleen can be done at all stages of pregnancy, infants from the first days of life and any patients during the entire disease several times, since ultrasound does not use any radiation technologies. How often you need to do an ultrasound of the spleen, the doctor decides. When it comes to ultrasound of the spleen, preparation for the procedure is devoid of special requirements.

Ultrasound of the spleen is an effective and, from a financial point of view, an affordable research method, therefore, if the spleen hurts, ultrasound can recognize the normal size in adults. Based on the deviations, the doctor will prescribe an effective treatment.

Indications for examination of the spleen

The main indication for ultrasound of the spleen is pain, which many diseases make themselves felt. If after the initial examination of the doctor the situation is not clarified, and the tests did not give a result, in most cases an ultrasound of the spleen is prescribed.

Ultrasound of the spleen is prescribed with a presumed increase in the organ in order to confirm or refute this, and also to find out the cause with a positive answer. In addition, diseases such as cirrhosis of the liver, leukemia, and infectious diseases are an absolute indication for ultrasound of the spleen. Ultrasound of the spleen may be prescribed to determine the location of metastases of a malignant tumor and with traumatic injuries of the abdominal cavity.

How to prepare for the procedure?

Preparation for ultrasound of the spleen is as follows: in 2-3 days, you will need to exclude from the diet foods that provoke gas formation, which can interfere with diagnosis. On each day of preparation, you must drink at least 1.5 liters of fluid, this will cleanse the digestive system. No food should be taken 5-6 hours before the procedure. Exception: pregnant women, infants and diabetics. If necessary, the doctor may prescribe drugs that improve the secretory function of the digestive system.

How is an ultrasound of the spleen done?

How should I prepare for an ultrasound of the spleen right in the office? To undergo an ultrasound in adults, you will need to lie on your back. The scanning sensor is moved from the costal arch to the end point of the organ. After the study in the supine position, the patient is turned on the right side, and the sensor is driven between the ribs until an image of the transverse sections of the spleen is obtained. If necessary, the patient may be told to lie on their stomach to continue the scan in the ribs. Since ultrasound of the spleen is a non-invasive research method, the patient does not experience any discomfort, except perhaps for the touch of a cold sensor.

Explanation of results

Directly during the ultrasound of the spleen, decoding is carried out by a specialist and further determines the course of the procedure. The specialist analyzes the position of the spleen relative to other organs: a healthy spleen is located on the left, at the top of the abdominal cavity, and the stomach is located in the middle of the spleen. During an ultrasound examination, it is important to pay attention to details: the diameter of the splenic vein of a healthy organ cannot be more than 1.5 cm, the echostructure of a healthy spleen must be homogeneous. Identified deviations are recorded in the conclusion. Subsequently, the doctor, based on the data obtained, makes a diagnosis and prescribes treatment.

Ultrasound norm of the spleen in adults

If the spleen is damaged, the size and norm in adults are determined by ultrasound in most cases, and other studies are not required. The norm of the spleen according to ultrasound in adults varies, depending on gender and individual characteristics of the body. The normal size of the spleen in men and women according to ultrasound is 8-14 cm in length, 3-5 cm in thickness and 5-7 cm in width. The mass of the spleen in women is 150-152 g, in men – 192-200 g.

Normal size of the spleen by ultrasound in children

How best to prepare a child for an ultrasound of the spleen, each parent decides for himself, since it is not recommended to move during the ultrasound. Indicators of the normal size of the spleen on ultrasound in children depend on age. In newborns, a healthy spleen does not exceed 4×3.8 cm in parameters, in children from 1 to 3 years old – 6.8×5 cm, from 3 to 7 years old – 8×6 cm, from 8 to 12 years old – 9×6 cm, from 12 to 15 years old – 10×6 cm. For children from 15 years old, sizes are considered normal, as in adults according to ultrasound.

What can ultrasound of the spleen show?

With the normal size of the spleen in adults and children, this organ “hides” behind the ribs. However, in case of abnormalities or pathologies, the spleen does not have normal sizes according to ultrasound and is visible from under the costal arch, shifting in the abdominal cavity. There are other symptoms that indicate damage and pathology of the spleen.


A sign of rupture during ultrasound of the spleen is fluid under the diaphragm or in the abdominal cavity, as well as uneven outlines of the organ. Rupture of the spleen occurs with aggressive mechanical action on it as a result of a blow or as a result of a disease, and it is possible to save the organ only in 1% of cases.


Hematoma or contusion of the spleen with untimely treatment can lead to rupture. Recognize hematoma by unevenly increased size, uneven outlines and bruising. Only ultrasound and other non-invasive research methods can see this damage.

Leukemic infiltration

Leukemic infiltration is a common injury to the spleen and liver in acute leukemia. Leukemic infiltration of the spleen is characterized not only by a change in its size, but also by an increase in echostructure, as well as a pointed edge and convex shapes. In the area of ​​​​the gates of the organ, lymph nodes increase.


An abscess affects the spleen against the background of other diseases and is a purulent formation that threatens to rupture in the future. Abscess of the spleen is characterized by a hypoechoic or mixed echostructure, as well as the presence of a cyst. Requires immediate treatment.

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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 referral for an ultrasound examination of the spleen can be given by 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), an infectious disease doctor (if some infectious diseases are suspected, 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 the 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 an 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 (either 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 (for example: 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, the presence of a 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.