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Approach to the child with an enlarged spleen

Kenneth L McClain, MD, PhD
Section Editor
Donald H Mahoney, Jr, MD
Deputy Editor
Carrie Armsby, MD, MPH


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.)

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Literature review current through: Nov 2017. | This topic last updated: Dec 06, 2017.
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