What is the normal spleen size in a 4-year-old male child?

Normal Spleen Size in a 4-Year-Old Male Child

The normal spleen length for a 4-year-old male child is approximately 9.0 cm, measured as the greatest longitudinal diameter from dome to tip at the hilum in the coronal plane on ultrasound. 1

Specific Measurement Guidelines

• At age 4 years, the upper limit of normal splenic length is 9.0 cm using a simple, reproducible sonographic method that measures the greatest longitudinal distance between the dome and tip of the spleen in the coronal view at the hilum 1

• The measurement should be obtained while the child is breathing quietly, using a coronal view that includes the splenic hilum 1

Age-Related Context

For reference, the progression of normal spleen size around this age includes:

• 2 years: 8.0 cm upper limit 1
• 4 years: 9.0 cm upper limit 1
• 6 years: 9.5 cm upper limit 1

Supporting Data from Multiple Studies

• A cross-sectional study of 317 Caucasian children demonstrated that spleen volume, transverse area, and diameter increase significantly with age (p<0.001), with strong correlation between age and spleen dimensions (r≥0.8) 2

• Another study of 458 healthy Caucasian children (ages 1 day to 15 years) confirmed significant correlations (Pearson r > 0.80; p < 0.001) between spleen length/volume and age, height, and weight 3

• Ethiopian data showed average spleen size of approximately 6.0 cm at 3-6 months, with the spleen-to-left kidney ratio remaining approximately 1:1 across all age groups 4

Clinical Pearls

• The spleen length correlates most strongly with height and age (r≥0.8), making these the most reliable parameters for determining normal size 2, 3

• Gender differences are minimal in this age group, with males and females showing comparable mean spleen lengths and volumes 3, 1

• The spleen-to-left kidney length ratio remains approximately 1:1 throughout childhood, which can serve as a useful internal reference when splenomegaly is suspected 4

Important Caveats

• Any spleen length exceeding 9.0 cm in a 4-year-old should raise suspicion for splenomegaly and warrant further investigation 1

• Body habitus variations exist, so correlation with the child's height and weight provides additional context, though the age-based guideline of 9.0 cm remains the primary reference 2, 3

• The single longitudinal measurement technique is both simple and reproducible, making it practical for routine clinical use 1