9%20ECOGRAFIA%20ABDOMINAL%20COMO%20CUANDO%20DONDE

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ABDOMINAL ULTRASOUND
A
B
C
Figure 6.1 (A) Left coronal view of the normal spleen demonstrating the main splenic artery and vein at the hilum.
(B) Transverse section (TS) demonstrating the splenic vein at the hilum. (C) By increasing the Doppler sensitivity, the
intrasplenic perfusion can be demonstrated. (D) An elongated or enlarged spleen can be displayed more fully using an
extended field of view. Shadowing from the ribs (arrows) is evident.
D
The spleen provides an excellent acoustic window
to the upper pole of the left kidney, the left
adrenal gland and the tail of the pancreas.
Splenic variants
Spleen size and shape are both highly variable, with
a gradual age-related decrease in volume. A splenic
length of below 12 cm is generally considered normal,
although this is subject to variation in shape
and the plane of measurement used.
Rarely, the diaphragmatic surface of the spleen
may be lobulated, or even completely septated.
This appearance may give rise to diagnostic uncertainty,
and Doppler may be helpful in establishing
the vascular supply, and differentiating this from
other masses in the left upper quadrant (LUQ), or
from scarring or infarction in the spleen.
The spleen may lie in an ectopic position, in the
left flank or pelvis, or posterior to the left kidney. The
ectopic (or wandering) spleen is situated on a long
pedicle, allowing it to migrate within the abdomen.