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Patient position:Start with the pt supine.Angle the probe between the ribs intercostally posterolaterally.Overlying bowel gas, overlying lung base or rib shadows can cause problems. Slowly roll the patient, to improve visualistaion.Try inspiration,expiration,distended abdomen,erectRarely the left lobe of the liver (if enlarged) may be used as a window to assess to superoanterior portion of the spleen.
The spleen has a homogeneous, "inverted comma" appearance.
Size:When it becomes enlarged it loses this shape and as it expands it becomes very rounded and sometimes appears as an egg shape extending beyond the Left kidney.Measurement:Normal is <12-14cm adult (or Volume <400/500cc).The spleen is enlarged if it covers the entire left kidney
- Splenomegaly >12-14 cm (or Volume >500cc)and becomes rounded.
- Infection- multiple echogenic foci (granulomata)
- Varices - portal hypertension
- Haematomas-intraparenchymal, subcapsular and pericapsular
- Splenic infarction
- Accessory spleen (splenunculi)- can appear at the site of the pancreatic tail, the inferior pole of spleen or in the splenic hilum.It can be mistaken for a mass or lymph node.
- Asplenia (no spleen)
- Polysplenia (>1)
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