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Splenomegaly

Splenomegaly ultrasound case study

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Reporting Panel

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Spleen Pathology

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Splenomegaly ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Mild Splenomegaly	View Report Line
2	Moderate splrnomegaly	-
3	Massive (Gross) splenomegaly	-
4	-	-
5	-	-

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CASE–1
Mild Splenomegaly

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Clinical History

A 35-year-old male presented with mild left upper abdominal discomfort and early satiety for several weeks. There was no history of fever, weight loss, jaundice, abdominal trauma, hematological disorder, chronic liver disease, or malignancy. Ultrasound examination of the abdomen was performed for further evaluation.

Ultrasound Findings

Ultrasound examination demonstrates a mildly enlarged spleen measuring approximately 13.4 cm in maximum craniocaudal length. The splenic parenchyma is homogeneous with normal echogenicity and preserved architecture. No focal splenic lesion, calcification, or cyst is identified. The splenic capsule is smooth and intact. Color Doppler demonstrates normal vascularity of the splenic parenchyma with a patent splenic vein. No perisplenic fluid collection is seen. The liver demonstrates normal size and echotexture without evidence of cirrhosis, and there is no sonographic evidence of portal hypertension or ascites.

Abdominal ultrasound. Longitudinal sonographic image demonstrates a mildly enlarged spleen measuring approximately 13.4 cm with homogeneous echotexture, smooth capsule, preserved splenic architecture, and no focal lesion, consistent with mild splenomegaly.

Report Line

The spleen is mildly enlarged, measuring approximately 13.4 cm in longitudinal length. Splenic echotexture is homogeneous with preserved architecture. No focal splenic lesion, calcification, infarction, or perisplenic collection is identified. Splenic vascularity is normal on Color Doppler examination. Findings are consistent with mild splenomegaly.

Impression

Mild splenomegaly (splenic length approximately 13.4 cm). Homogeneous splenic echotexture without focal lesion or sonographic evidence of portal hypertension.

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Recommendation

Correlate with clinical findings and laboratory investigations including complete blood count, liver function tests, and peripheral blood smear where appropriate. Further evaluation for infectious, hematologic, hepatic, or systemic causes should be guided by the clinical presentation. Follow-up ultrasound may be considered if symptoms persist or progressive splenic enlargement is suspected.

Key Learning Points

• Mild splenomegaly is generally defined as a splenic longitudinal length of approximately 12–14 cm in adults.
• Ultrasound is the preferred first-line imaging modality for assessing splenic size and parenchymal morphology.
• Homogeneous splenic echotexture with preserved architecture suggests uncomplicated splenic enlargement.
• Carefully evaluate the liver, portal vein, and splenic vein to identify evidence of portal hypertension.
• Common causes include viral infections, hematological disorders, portal hypertension, inflammatory diseases, and systemic infections.
• Color Doppler helps assess splenic perfusion and the patency of the splenic and portal venous systems.
• Clinical correlation and laboratory evaluation are essential to determine the underlying etiology of splenomegaly.

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