The spleen is the largest accumulation of lymphoid tissue in the body. It has an important defense against antigens that reach the blood circulation. The presence of splenomegaly is important in diagnosis of many diseases, such as portal hypertension and bilharzial diseases. Gross splenomegaly can be detected both clinically and sonographically, however there is difficulty in the diagnosis of mild splenomegaly clinically. Sonography is an established and safe method for calculation of splenic length and spleen to left kidney ratio as it may be a simple way to diagnose mild splenomegaly. Also it can be obtained without exposing the patient to hazards of ionizing radiation, so sonography is the most likely one.
The aim of this study was the measurement of normal splenic length in infants and children in Qalubia governate and correlation with changes in age, sex, height, weight and body surface area. Also the length of left kidney was recorded and the ratio between the splenic length and the length of left kidney was determined to diagnose mild splenomegaly.
This study included 100 normal infants and children from both sexes. There ages ranged from 1 day to 17 years, divided into 6 groups. There were 50 males and 50 females. These cases were subjected for complete history, physical examination and laboratory tests to exclude any renal disease. The splenic length, the transverse diameter and the left kidney length were measured by using ultrasound technique. Also the splenic to left kidney ratio was calculated. During examination, the age, sex, height, weight and body surface area were recorded.
The results of the present study showed that:
1- There was progressive increase in all body parameters with age and the rate of growth of these body parameters was much more during the 1st year of life and at the time of puberty.
2- The mean body parameters of female groups were more than the mean body parameters of male groups but this differences statistically was insignificant.
3- There was no significant difference for splenic length and transverse diameter and left kidney length between males and females in all age groups, except that above 15 years of age, this sex difference for the splenic length was very highly significant.
4- The mean splenic/kidney ratio of constant in all age groups with the mean value of 1.02.
5- The splenic length was highly correlated with height of the body with the ( r ) value was 0.94.
6- The transverse diameter of the spleen was correlated with height of the body ( r ) was 0.74, but to a lesser extent than that of splenic length with height .
7- The length of left kidney also was highly correlated with height of the body ( r ) was 0.93.
Conclusions
1- Sonography provides a simple way to assess the renal and splenic growth without any risk of radiation.
2- The body height of the child rather than his age showed the best correlation with renal length and splenic parameters.
3- A simple method to diagnose mild splenomegaly, is to use spleen/kidney ratio that was found to be constant at any age group.
4- The correlation of transverse diameter of the spleen with height was less than the correlation of splenic length with height. Thus during sonographic assessment of the splenic parameters and their correlation with the body parameters, the splenic length and the patient height are the most important determining factors.
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