17. SPLEEN OF A CHILD

The spleen in a child is a vital, fist-sized lymphatic organ located in the upper left abdomen that filters blood, removes old red blood cells, and helps fight infections. It is normally palpable in many newborns, infants, and toddlers. Its size increases with age, ranging from $\sim$4.5 cm in infants to over 10 cm in adolescents. 

Radiopaedia +4

Key Aspects of the Pediatric Spleen

• Location & Function: Positioned behind the 9th-11th ribs, it acts as a filter for blood and part of the body's defense mechanism.
• Normal Size by Age (Approximate upper limits):
  • 3–6 months: 5.8–6.4 cm.
  • 1–2 years: 7.5 cm.
  • 4–6 years: 8.8 cm.
  • 10–12 years: 10.9 cm.
  • 15+ years: $\sim$12-13 cm.
• Palpability: A spleen easily felt below the ribs in a child over 3–4 years old is generally considered abnormal.
• Common Conditions:
  • Splenomegaly (Enlarged Spleen): Frequently caused by viral infections (e.g., mononucleosis), bacterial infections, or hemolytic anemia.
  • Trauma: Injury from sports or accidents can cause bruising or rupture (graded 1–5).
  • Sickle Cell Disease: Can cause an enlarged spleen early in life and a shrunken, non-functional spleen later.

• Management: In children with splenic issues or those who have had a splenectomy (removal), vaccinations (pneumococcal, HIB, meningitis) and sometimes prophylactic antibiotics are necessary due to high infection risk. 

  Radiopaedia +7

Disclaimer: If you are concerned about a child's health, particularly regarding abdominal pain or injury, please consult a pediatrician.