Journal of Ultrasound

, Volume 22, Issue 4, pp 503–512 | Cite as

Ultrasonography of the pediatric spleen: a pictorial essay

  • Marco Di Serafino
  • Francesco VerdeEmail author
  • Federica Ferro
  • Norberto Vezzali
  • Eugenio Rossi
  • Ciro Acampora
  • Iacopo Valente
  • Piernicola Pelliccia
  • Stefania Speca
  • Gianfranco Vallone
Pictorial Essay


In infants and children, the spleen is involved in many pathological processes, whether those processes are isolated or related to systemic diseases. Pathology of the pediatric spleen includes congenital anomalies, splenomegaly, trauma, focal lesions, infarction, and tumors. Ultrasonography (US) is a widely available, fast, noninvasive imaging technique to assess the size, shape, and position of the spleen, as well as to define splenic echotexture. US is capable of screening for splenic disorders without the risk of ionizing radiation; it is the initial imaging examination performed to evaluate suspected splenic pathology, providing clinicians with helpful decisional support. US plays an important role in the detection of even very small amounts of hemoperitoneum, a herald of significant abdominal organ injury, in pediatric blunt abdominal trauma. Moreover, contrast-enhanced US may allow early detection of splenic injuries, ideally minimizing children’s risk from radiation exposure. This pictorial essay illustrates the normal ultrasound appearance of the pediatric spleen and the sonographic findings which may guide clinicians to a correct diagnosis of pathologic conditions.


Pediatric sonography Congenital anomalies Splenomegaly Focal splenic lesions Trauma Tumors 


In età pediatrica la milza è coinvolta in molti processi patologici, che possono manifestarsi come entità isolate o possono essere secondarie a malattie sistemiche. I quadri patologici splenici includono anomalie congenite, splenomegalia, trauma, lesioni focali, infarti e tumori. L’ecografia è una metodica largamente disponibile, veloce e non invasiva che permette di determinare le dimensioni, la posizione e la morfologia della milza e di caratterizzarne inoltre l’ecotessitura parenchimale. L’esame ecografico permette di identificare precocemente le alterazioni spleniche senza il rischio di radiazioni ionizzanti e viene per questo motivo utilizzato come metodica di imaging iniziale per valutare quadri sospetti di patologia splenica fornendo ai clinici un utile supporto decisionale. Nei traumi addominali chiusi, l’ecografia svolge un ruolo importante nell’identificare quantità persino esigue di emoperitoneo, reperto associato a significative lesioni degli organi addominali. Inoltre, l’utilizzo dell’ecografia con mezzo di contrasto potrebbe permettere di identificare precocemente lesioni traumatiche della milza, e ridurre, idealmente, al minimo le radiazioni nei pazienti pediatrici. Questo pictorial essay illustra il normale aspetto ecografico della milza in età pediatrica ed i reperti ecografici che possono condurre alla corretta diagnosi di processi patologici.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and its later amendments.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Informed consent

Additional informed consent was obtained from all the patients for which identifying information is not included in this article.


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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2018

Authors and Affiliations

  • Marco Di Serafino
    • 1
  • Francesco Verde
    • 2
    Email author
  • Federica Ferro
    • 3
  • Norberto Vezzali
    • 3
  • Eugenio Rossi
    • 4
  • Ciro Acampora
    • 1
  • Iacopo Valente
    • 5
  • Piernicola Pelliccia
    • 6
  • Stefania Speca
    • 7
  • Gianfranco Vallone
    • 2
  1. 1.Radiology Department“Antonio Cardarelli” HospitalNaplesItaly
  2. 2.Paediatric Radiology Department“Federico II” University HospitalNaplesItaly
  3. 3.Radiology DepartmentRegional Hospital of BolzanoBolzanoItaly
  4. 4.Radiology Department“Santobono-Pausilipon” Children HospitalNaplesItaly
  5. 5.Radiology and Neuroradiology Imaging Diagnostic DepartmentAgostino Gemelli” University Hospital, IRCCSRomeItaly
  6. 6.Department of PediatricsUniversity of Chieti-PescaraChietiItaly
  7. 7.Department of RadiologySacro Cuore” University HospitalRomeItaly

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