Arkles L B, Gill G D, Molan M P
Med J Aust. 1986 Jul 7;145(1):15-7. doi: 10.5694/j.1326-5377.1986.tb113733.x.
It is widely accepted that a palpable spleen in the adult population is always enlarged and pathological. The aim of this study was to assess the validity of this statement. As a routine, our protocol for liver-spleen studies includes liver pliability, which demonstrates the level of the hemidiaphragms at full inspiration and expiration, as well as splenic size and colloidal uptake. Sixteen hundred 99mTc sulphur colloid liver-spleen studies, which had been performed in our Department, were reviewed. In 21 patients, who had been referred with "splenomegaly for investigation", the scintigraphic splenic size was 13 cm posterior length or less. In this group, splenic palpability was confirmed by at least two clinicians. Follow-up did not reveal any evidence of splenic disease in 18 of the 21 patients. In a separate postmortem follow-up of 123 sequential liver-spleen scans, 100 patients were noted to have a scintigraphic splenic size of 13 cm posterior length or less. This was shown to be a reliable upper limit of normal because 98% of spleens in this group weighed 250 g or less and were normal at post-mortem examination. This study demonstrates that a palpable spleen is not necessarily enlarged or pathological.
成人可触及脾脏通常被认为总是肿大且病理状态的。本研究旨在评估这一说法的正确性。作为常规操作，我们的肝脾检查方案包括肝脏柔韧性，即展示深吸气和深呼气时半膈肌的水平，以及脾脏大小和胶体摄取情况。我们回顾了在本部门进行的1600例99mTc硫胶体肝脾显像检查。在21例因“脾肿大待查”转诊的患者中，脾脏显像的前后径为13厘米或更小。在这组患者中，至少有两名临床医生确认可触及脾脏。随访发现21例患者中有18例没有脾脏疾病的任何证据。在对123例连续肝脾扫描进行的单独尸检随访中，发现100例患者脾脏显像的前后径为13厘米或更小。这被证明是正常的可靠上限，因为该组中98%的脾脏重量为250克或更小，尸检时正常。本研究表明，可触及的脾脏不一定肿大或处于病理状态。
