Congenital Splenic Anomalies in a Child: Incidental Ultrasonographic Findings and a Case Report

Abstract

The spleen is the largest encapsulated lymphoid and intraperitoneal organ in the human body located in the left hypochondrium, and consisting of the white pulp for the immune system and the red pulp for phagocytoses of blood elements. Congenital anomalies of the spleen may vary, ranging from those of the shape, size and location, among which are lobulation, clefts and notches, accessory spleen, wandering spleen and polysplenia. This is a 10-year-old male child referred for an abdominal and pelvic ultrasonography on account of urinary infection (UTI), had no history of trauma and instrumentation to the abdomen or left hypochondrial region. The abdominopelvic ultrasonogram showed a normal sized spleen with a diameter of 110mm, that showed a deep and central fissure extending superior and right medially on the diaphragmatic surface of the spleen. Linear echolucent areas are also demonstrated bilaterally; fissures, multiple notches are also noted on the superior border and clefts; appearing as linear echolucent areas on the superior border dividing it in to lobules. These clefts measure about 2cm from the superior border of the spleen. No accessory or multiple splenic tissues or wandering spleen is however demonstrated. The abdominal organs show normal situs. We report the ultrasonographic appearance of congenital anomalies involving the shape of the spleen in a 10-year-old child due to its peculiar presentation.