Approach to the child with an enlarged spleen
- Kenneth L McClain, MD, PhD
Kenneth L McClain, MD, PhD
- Professor of Pediatrics
- Texas Children's Cancer Center/Hematology Service
- Baylor College of Medicine
This topic reviews the approach to the child whose spleen is enlarged on physical examination and/or is more than minimally enlarged on abdominal imaging. The clinical or diagnostic significance of a spleen that is not palpable on physical examination and is only minimally enlarged on imaging is uncertain.
The approach to the adult patient with splenomegaly and other splenic disorders is discussed separately. (See "Approach to the adult with splenomegaly and other splenic disorders".)
The following terms are used in this topic:
●Splenomegaly – The term splenomegaly can refer to a finding on physical examination or on imaging (or both):
•On physical examination, splenomegaly is generally defined as a palpable splenic edge felt >2 cm below the left costal margin. A palpable spleen tip may be a normal finding in up to 30 percent of neonates; the frequency drops to approximately 10 percent in healthy school-age children and <3 percent in young adults. (See 'Examination of the spleen' below.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- OVERVIEW OF SPLENIC FUNCTION
- CAUSES OF SPLENOMEGALY
- Hematologic malignancy
- Other lymphproliferative disorders
- Hemolytic anemia
- Liver disease/portal hypertension
- Portal vein thrombosis
- Disorders of immune regulation
- Storage disease
- Space-occupying lesions
- CAUSES OF A MASSIVELY ENLARGED SPLEEN
- Physical examination
- - Examination of the spleen
- - Other exam findings
- Initial diagnostic testing
- - Imaging
- - Laboratory evaluation
- DIAGNOSTIC APPROACH
- SUMMARY AND RECOMMENDATIONS