Diagnostic Ultrasound - Abdomen and Pelvis

Splenomegaly
(Left) US in a 92-year-old man
with clinical syndrome of
hypersplenism (pancytopenia
and splenomegaly ſt) is
shown. The spleen measured
20 x 8 x 21 cm (width x
thickness x length). Note left
kidney for comparison .
(Right) US in a 81-year-old
man with splenomegaly ſt
due to chronic
myelomonocytic leukemia
(CMML) is shown. The spleen
length measured 16.7 cm,
thickness 9.7 cm. Note a
geographic hypoechoic region
at the pole with linear
echogenic bands ,
compatible with an infarct.
Diagnoses: Spleen
(Left) US in a 64-year-old man
with alcoholic cirrhosis shows
severe splenomegaly (length
of 22.8 cm). Multiple tiny
echogenic foci with mild
posterior acoustic shadowing
represent sequelae of old
granulomatous disease. Note
the presence of perisplenic
ascites . (Right)
Corresponding CT shows
severe splenomegaly ſt,
ascites , and chronic
(partially calcified) splenic vein
and portal confluence
thrombus .
(Left) Color Doppler US in a
52-year-old man with
alcoholic cirrhosis and
splenomegaly (14.9 cm in
length) shows the reversal of
flow in the splenic vein by
color ſt and spectral
waveform (abnormally
directed towards the spleen),
consistent with severe portal
hypertension. (Right)
Assessment of the splenic vein
ſt at the midline (deep to the
pancreatic body ) in the
same patient shows reversal
of the normal direction of
flow.
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