All issues > Volume 31(7); 1988

Original Article

J Korean Pediatr Soc. 1988;31(7):833-840. Published online July 31, 1988.

Study on Diagnostic Methods for Spleen in Complex Heart Disease.

Jung Yun Choi¹, Yong Soo Yun¹, Chung Il Noh¹, Chang Yee Hong¹, Kyung Mo Yeon², In One Kim²

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
²Department of Pediatric Radiology, College of Medicine, Seoul National University, Seoul, Korea

Received: June 9, 1988;  Accepted: June 9, 1988.

Abstract

Thirty one cases of congenital heart disease with suspicious splenic anomaly were prospectively studied at Seoul National University Children’s Hopsital from October, 1986 to February, 1988 in order to determine the sensitivity and the specificity of various non-invasive diagnostic methods for splenic status. In most cases, splenic status was confirmed by abdominal aortography. Each case had chest X-ray, abdominal X-ray, bronchus tomography, electrocardiogram, echocardiography, abdomi- nal ultrasound examination, peripheral blood smear for Howell-Jolly body and radioisotope spleen selective scan using technetium. On the basis of aortographic findings and, other findings if necessary, splenic status was classified into 1) asplenia, 2) polysplenia, 3) normal spleen, 4) mirror image spleen. Radioisotope scan and abdominal ultasound examination were very sensitive and specific to detect asplenia, normal and mirror image spleen. But neither of them were sensitive to find polysplenia. In contrast, left isomerism on bronchus tomography and inferior vena cava interruption were good indicator of polysplenia. Relative position of inferior vena cava and aorta at 12th thoracic vertebrae level was neither sensitive or specific to asplenia. Three fourth of asplenia showed Howell-Jolly body. P wave axis on electrocardiogram was not helpful to define splenic status. Simple chest and abdominal X-ray were not helpful either. There was no single non-invasive diagnostic method applicable to all splenic status, but two or more methods will make accurate diagnosis of splenic status.

Keywords :Asplenia, Polysplenia, Cardiosplenic syndrome, Right isomerism, Left isomerism.