Sonographic determination of spleen to left kidney ratio among Igbo school age children of south east Nigeria

Background: Clinical determination of mild splenomegaly is notoriously inaccurate. Objectives: To determine sonographically the spleen to left kidney ratio according to age and somatometric parameters among school age children in a tropical environment. Methods: A cross sectional study and convenience sampling were done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6 - 17 years at the University of Nigeria Medical Centre, Nsukka. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen and left kidney lengths were obtained using appropriate techniques. The weight and height of the subjects were obtained with the participants wearing light weight street clothes without shoes. Results: Measurement of spleen and left kidney lengths were reliable within and between sonographers. The spleen and left kidney lengths were not statistically different in boys and girls (p 0.05). The spleen to left kidney ratio according to age and somatometric parameters is constant at about 1.13 with 1.3 as the upper limit of normal in the studied population. Conclusion: Sonography can be used to detect mild splenomegaly if the spleen to left kidney ratio is greater than 1.3 in the absence of renal disease among school age children.