Normal splenic size in infants and children: sonographic measurements

The purpose of this study was to establish guidelines for normal splenic size at different ages by using a simple and reproducible sonographic method. Two hundred thirty patients, from neonate to 20-year-old, had sonography because of abdominal and/or pelvic problems unrelated to the spleen. Findings on sonograms of the liver and kidneys were normal in all cases. Splenic size was measured by obtaining a coronal view that included the hilum, while the patient was breathing quietly. The greatest longitudinal distance between the dome of the spleen and the tip (splenic length) was measured and correlated with age, height, and weight. The following guidelines are proposed for the upper limit of normal splenic length based on this simple, easy to use, one-measurement technique: splenic length no greater than 6.0 cm at 3 months, 6.5 cm at 6 months, and 7.0 cm at 12 months, 8.0 cm at 2 years, 9.0 at 4 years, 9.5 cm at 6 years, 10.0 cm at 8 years, 11.0 cm at 10 years, 11.5 cm at 12 years, 12.0 cm at 15 years or older for girls, and 13.0 cm at 15 years or older for boys. Twenty-two patients with known abnormalities of the spleen were randomly selected and their splenic lengths compared with the proposed guidelines; in each case, the length of the spleen exceeded the upper limit of normal for that age. Normal values of a single measurement of the greatest longitudinal diameter of the spleen, from the dome to the tip measured at the hilum in the coronal plane, were obtained in patients from newborn to 20 years old.