Spleen dimensions: normal in adults, area, dimensions in mm
The spleen is an organ located in the left hypochondrium. The spleen consists of a pulp that is retained by a dense connective tissue capsule, from which the trabeculae (cords) extend into the pulp, strengthening the soft parenchyma.
In accordance with the histological structure, the spleen has two layers: white and red. The red pulp is based on supporting cells that are intertwined with each other, and the cells formed by them contain cells that absorb damaged red blood cells and foreign particles. This layer is densely penetrated by a network of the smallest capillaries through which blood flows to the pulp cells.
White pulp is a collection of specific blood cells (white cells - leukocytes) and looks like white islands against the background of red capillaries. In addition, numerous small lymphatic nodules are found in the white pulp.
In order to diagnose various pathologies of an organ, it is necessary to know its exact dimensions, which are determined percussionally or by ultrasound.The size of the spleen in health and disease are described in this article.
The peritoneum covers the organ completely (except for the gate). The outer plane of the spleen is adjacent to the diaphragm (its costal part). The organ is projected on the left diaphragmatic costal sinus, between the 9th and 11th ribs along the axillary midline.
The back of the spleen is 4-6 cm from the spine, at the level of the 10-11th vertebrae (thoracic). The form of the body is oval or oblong, can be wide and short in children or narrow and long in adults. The spleen has two poles: a rounded posterior, which faces the spine, and a pointed anterior, which is directed to the ribs.In addition, there are two surfaces: the diaphragmatic (external) and visceral (internal). The organ gate is located on the visceral surface (center).
The size of the body can vary in the presence of pathologies, as well as the patient's age. The size of the spleen in an adult (norm): thickness 3-4 cm, width up to 10 cm, length up to 14 cm.
The spleen is quite mobile due to the fact that it is connected with the stomach and the diaphragm (that is, moving organs).
The location of the spleen relative to other organs
The spleen is located under the lung, next to the left kidney, pancreas and intestines (thick), as well as the diaphragm.
The visceral surface is dotted with a multitude of irregularities formed by the action of other organs on it. These irregularities are pits, named in accordance with the body that puts pressure on the spleen:
- gastric concavity;
- the pit is intestinal;
- renal fossa.
In addition, the spleen is closely connected with other organs through blood vessels. That is why with the presence of pathological processes, for example, in the pancreas, consisting of the head, body, tail, with the size, norm in adults, the spleen may also increase.
The proximity of other organs to the spleen determines the rules of diagnosis, for example, during an ultrasound scan, a comprehensive examination is performed to determine the size and condition of the liver, pancreas and so on parenchyma, and during the initial examination, the doctor consistently palpates the intestines, stomach, liver, pancreas and spleen, then with the help of percussion determines the size of the bodies to eliminate their increase / decrease.
The main functions of the body are as follows:
- participation in the blood formation of the fetus;
- the filtration function (spleen cells absorb and dissolve bacteria that have entered the blood (pneumococci, plasmodia), damaged red blood cells and other cells, that is, perform phagocytosis);
- immune (the body takes part in the formation of immunity, producing antibacterial cells);
- participation in metabolic processes (iron accumulates in the spleen, used to produce hemoglobin);
- the organ works as a blood depot, that is, if necessary, the blood stored in the spleen enters the bloodstream;
- the spleen is able to compensate for the increase in blood pressure in the portal vein pool.
Spleen - sizes. Norm in adults and children
- Newborns: length 40mm, width 38mm.
- Children 1-3 years old: length 68mm, width 50mm.
- Kids 3-7 years: length 80mm, width 60mm.
- Children 8-12 years old: length 90mm, width 60mm.
- Teenagers 12-15 years: length 100mm, width 60mm.
- The size of the spleen is the norm in an adult in mm: length 120, width 60.
The splenic vein normally has a diameter of 5-6 (up to 9) mm.
The size of the spleen is normal in adults, the area at the maximum slice is 40-45 cm.
The volume of the body is determined in accordance with the Koga formula: 7.5 * area - 77.56.
Normal body size
What sizes of the spleen are considered the norm in adults is indicated above, the weight of a healthy organ is 150-170 g (up to 250 g). In healthy people, the spleen is completely covered by the lower left ribs and it can be felt only with a significant increase in the body when its mass increases to 400 g.
In the case of a slight increase, specialized equipment is needed for the diagnosis of pathology, on which an examination is performed, for example, an ultrasound scan.
The upper limit of the size of the spleen (the norm in adults) with ultrasound is 5 * 11 cm (respectively, thickness and length). However, the dimensions determined by ultrasound should be correlated with the weight and age of the patient.
Diagnosis of pathologies of the spleen
The following methods allow to determine the size and condition of the organ parenchyma (and, accordingly, to conclude about the presence / absence of diseases):
- percussion, palpation;
- x-ray examination;
Percussion is used to determine the size of the organ during the initial inspection. Percussion should be quiet. The patient is positioned vertically (arms extended forward) or horizontally (on the right side,with the arm bent at the elbow or the left hand lying freely on the chest, while the right hand is under the head; the left leg is seen in flexes in the hip and knee joints, and the right leg stretches).
Percussion border (size) of the spleen
- Upper border: finger-plysimetr is located on the axillary midline in the region of 6-7 intercostal space and moves down until the change of pulmonary sound is dull.
- Lower boundary: finger-plysimeter is placed along the axillary midline, downwards from the costal arch and moves up to the dullness of the sound.
- Anterior border: finger-plysimeter is placed on the abdominal front wall, to the left of the navel (around 10 intercostal space). Percussion should be before the occurrence of blunting. Normally, this boundary is located 1-2 cm to the left of the axillary anterior line.
- Posterior border: The plysimeter is perpendicular at 10 edges, between the axillary posterior and scapular lines, and percussion is carried out back to front until a dull sound appears.
After that, the doctor measures the distance between the lower and upper boundaries of the organ, that is, its diameter, which is normally equal to 4-6 cm and is between 9 and 11 edges.Following this, it is necessary to determine the distance between the posterior and anterior borders, that is, the length of the spleen (normally equal to 6-8 cm).
Spleen sizes: the norm in adult ultrasounds
Due to the fact that most often the pathology of the spleen is manifested by its increase, the main task of this study is to determine the size of the organ. During the ultrasound, determine the thickness, width and length of the body. Thus, the norm of the size of the spleen in an adult male: length 12 cm, thickness 5 cm, width 8 cm. However, the size of the organ can vary within 1-2 cm, depending on the constitution, gender and age of the patient.
In addition to size, the sonologist determines the shape of the organ, which may also have some differences in different patients. If a slight increase is determined only by a single size, then this is usually a variant of the norm. However, if 2 or 3 sizes are enlarged, splenomegaly is suspected.
In addition, an ultrasound scan shows the location of the spleen relative to other organs and determines the structure of the tissue (ie, the presence / absence of cysts, tumors, etc.) and the diameter of the vessels: the splenic veins (5-8 mm) and arteries (1-2 mm).
In some cases, an ultrasound determines the area of an oblique maximum section of the organ. This indicator more accurately reflects the degree of increase / decrease of the body. It is quite simple to determine the area: the smallest size of the spleen is multiplied by the largest. The area of the spleen (the size of the norm in adults) is 15.5-23.5 cm
If necessary, calculate the volume of the body.
Interpretation of results
Deviations in size (increase in length and width) of the organ indicate splenomegaly, which is a consequence of a variety of infections (sepsis, recurrent, sypnyh, typhoid, typhoid, brucellosis, malaria), blood pathologies (thrombocytopenic purpura, leukemia, lymphogranulomatosis, hemolytic anemia), the psychology of the lymphocytopenia, leukemia, lymphogranulomatosis, hemolytic anemia, the pathology of the blood, the pathology of the blood (purpura, thrombocytopenic, leukemia, lymphogranulomatosis, hemolytic anemia) (cirrhosis, hepatosis), metabolic disorders (amyloidosis, diabetes mellitus), circulatory disorders (thrombosis of the portal or splenic veins), pathologies of the spleen (injuries, tumors, inflammation, echinococcosis).
In case of infectious acute pathologies, the spleen acquires a rather soft consistency (more often in sepsis). In the case of chronic infections, blood diseases, portal hypertension, neoplasms and amyloidosis, the organ becomes denser.In the presence of echinococcosis, cysts, gum syphilitic, myocardial spleen, the surface of the organ becomes uneven.
A painful spleen occurs in heart attacks, inflammations or thrombosis of the splenic vein.