Measurements of the normal size of spleen and spleen to left kidney ratio among sudanese children up to five years age using ultrasonography

Awadia G. Suliman, Mohammed A. Adam, Rihab Y. Ahmed, Raga A. Aburaida, Ahmed A. Ebrahim


Background: Knowledge of the normal range of spleen size in the population being examined is very important because there are many different pathological conditions that may alter in spleen size. Also, gender, height, weight and BMI of individual, affect the splenic length and could result in incorrect interpretation of splenic measurements, spleen to left kidney ratio is one of recent parameter mention in literature aid in diagnosis of splenomegaly in children.

Methods: The study was a cross-sectional study conducted in Khartoum state at Al-Buluk and Gaafar Ibnauf Paediatric Tertiary Hospital during the period from March 2018 to August 2018. A total of 101 children (males and females) with aged ranged 1 month to 5 years included in study. A transabdominal scan was performed, and measurement of spleen and left kidney taken after an ethical verbal consent from their parents, then data analyzed by SPSS, Mean±SD. Deviation for study variables calculated then correlation between patients factors and ultrasound measurements done.

Results: The study found that the mean measurements of the normal size of the spleen and spleen to left kidney ratio for children up to five years of age, Splenic length was 7.24±1.12 cm, width was 3.83±0.81 cm , thickness 2.91±0.55 cm and spleen to left kidney ratio was 1.04±0.0.70 ranged (0.86-1.23). The male have larger spleen than female with no statistically significant differences in spleen sizes between the sexes. There was a strong significant correlation between age, weight, height  spleen and left kidney length (p<0.01)respectively and a moderate association with BMI (p<0.05).

Conclusions: Spleen and left kidneys was growing rapidly and similarly in infant up to one year of life 1 mm\1 mm for each month and then decreasing growth rate of kidney in relate to spleen for 1 mm growth of spleen kidney grow 0.8 mm in up to five years of age. There was strong significant positive correlation between spleen and left kidney measurement with age, height, weight of individual. The spleen to left kidney ratio for children up to five years ranged (0.86-1.23) with mean 1.04, so if the ratio less or more than this ranged it should be considered in clinical context for diagnosis of splenomegaly or shrunken spleen in children up to five years of age.


Left kidney length, Spleen length, Spleen to left kidney ratio, Ultrasound

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Megremis SD, Vlachonikolis IG, Tsilimigaki AM. Spleen length in childhood with US: normal values based on age, sex, and somatometric parameters. Radiology. 2004;231(1):129-34.

Lamb PM, Lund A, Kanagasabay RR, Martin A, Webb JA, Reznek RH. Spleen size: how well do linear ultrasound measurements correlate with three-dimensional CT volume assessments?. Br J Radiol. 2002;75(895):573-7.

Rumack CM, Wilson SR, Charbouneau JW, Deborah Levine, eds. Diagnostic Ultrasound. 4th ed. philadelphia: Mosby; 2011: 1334.

Brant WE, Helms CA. Fundamentals of Diagnostic Radiology, 3rd Ed. Lippincott Williams and Wilkins, 2007: 790-3.

Davis ID, Abner ED. Glomerular disease. In: Kliegman RF, Behrman RE, Jenson HB, Stanton BF eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia: Saunders. 2007:2163.

Carol M.Rumack, Levine, Deborah, editors. Diagnostic Ultrasound. 5th ed. philadelphia: Elsevier. 2018;139-33.

Chris Harringgton. sonographic principles and instrumentation. 3rd ed. Manitoba Canada: Burwin institute. 2010:40-92.

Al-Timimy QA, Al-Naddawi MN, Joori SN. Ultrasound assessment of normal splenic length and spleen to left kidney ratio in sample of Iraqi population. Al-Kindy Col Medi J. 2014 Dec 1;10(2):56-61.

Eze CU, Agwu KK, Ezeasor DN, Agwuna KK, Aronu AE: Sonographic determination of spleen to left kidney ratio among Igbo school age children of south east Nigeria. Afr Health Sci. 2014;14(1): 246-54.

Otiv A, Mehta K, Ali U, Nadkarni M. Sonographic Measurement of Renal Size in Normal Indian Children. AWHO. 2012;49:523.

Nalli R, Anita S, Reddy CV. To Determine the Renal Size in Normal Children by Ultrasonography. IOSR J Dental Medi Sci. 2016;15(4):41-5.

Oh MS, Hwang G, Han S, Kang HS, Kim SH, Kim YD, et al. Sonographic growth charts for kidney length in normal Korean children: a prospective observational study. J Kore Medi Sci. 2016 Jul 1;31(7):1089-93.

Dhingra B, Sharma S, Mishra D, Kumari R, Pandey RM, Aggarwal S. Normal values of liver and spleen size by ultrasonography in Indian children. Indi Pediatr. 2010 Jun 1;47(6):487-92.