Definition: palpable spleen.
The normal spleen is 12 by 7 by 4 cm. Splenomegaly is measured in cm below the costal margin.

Differentials: enlarged kidney, colonic mass, gastric mass, mass in tail of pancreas.

Spleen Kidney
Enlarges toward the Right iliac fossa Left iliac fossa
Bimanually palpable No Yes
Moves down with inspiration Yes Slightly
Can get above it No Usually
Medial notch Sometimes No
Percussion note dull resonant (overlying bowel)



  1. Hypersplenism


Any cause of splenomegaly can cause hypersplenism.