Ultrasound images Splenic variants
Spleen size and shape are both highly variable, with a gradual age-related decrease in volume. A splenic length of below cm is generally considered normal,
although this is subject to variation in shape and the plane of measurement used. Rarely, the diaphragmatic surface of the spleen may be lobulated, or even completely septated. This appearance may give rise to diagnostic uncertainty, and Doppler may be helpful in establishing the vascular supply, and differentiating this from other masses in the left upper quadrant (LUQ), or from scarring or infarction in the spleen.
The spleen may lie in an ectopic position, in the left flank or pelvis, or posterior to the left kidney. The ectopic (or wandering) spleen is situated on a long
pedicle, allowing it to migrate within the abdomen The significance of this rare condition is that the pedicle may twist, causing the patient to present
acutely with pain from splenic torsion. Ultrasound demonstrates the enlarged, hypoechoic organ in the abdomen, with the absence of the spleen in its
normal position.
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