Enlarged Spleen (Splenomegaly) - Diagnosis

How was your enlarged spleen diagnosed?

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How is an enlarged spleen diagnosed?

Most often an enlarged spleen is found incidentally on physical examination by the health care practitioner. The spleen usually is small enough to hide underneath the left rib cage in the upper abdomen. The enlarged spleen tip can be felt in the left upper quadrant of the abdomen and as it continues to enlarge the tip moves towards the right lower quadrant. In some thin people, the spleen can be felt in the abdomen but is normal in size. An enlarged spleen measures about 12 to 20 cm (4.5 to 8 inches) in any dimension while a spleen greater than 20 cm (8 inches) is considered severe enlargement.

If there is concern that the spleen is enlarged, blood tests may be considered to assess the cause of the enlargement. Common tests may include a complete blood cell count (CBC) looking for abnormal red or white blood cells, a peripheral smear to assess at the types and shapes of blood cells or a monospot, to confirm or rule out the diagnosis of infectious mononucleosis. Other tests evaluating liver or heart function may be considered if clinically indicated.

An abdominal ultrasound, CT, or MRI of the abdomen may be used to evaluate the size of the spleen and to look for other abnormalities in the abdominal cavity that may be associated with splenomegaly.

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