Enlargement of the spleen as an incidental finding on CT in post-partum females with fever.

OBJECTIVE

The aim was to evaluate whether enlargement of the spleen on CT in a post-partum female with fever is a common phenomenon.

METHODS

In this retrospective institutional review board-approved study, the spleen was measured by CT in 77 females (average age 30.7 years) examined for post-partum fever and a control group of 58 febrile females imaged for suspected appendicitis (average age 29.7 years). The splenic length, width and thickness were measured and used to calculate the splenic index. The measurements of both groups of patients were compared. The size of the spleen was assessed again in 12 of the 77 post-partum female who had a follow-up CT for unrelated reasons. Continuous variables were compared, by groups, using analysis of variance (ANOVA). ANOVA with repeated measures was used to evaluate changes over time. A p-value <0.05 was considered significant.

RESULTS

The length, thickness and width of the spleen were significantly larger in the patients imaged after delivery compared with those in the control group (p<0.001 for all three comparisons). The mean splenic index was 686.6 cm(3) in the post-partum group and 408.1 cm(3) in the control group (p<0.001). The splenic dimensions and index were significantly smaller in the 12 post-partum females who had a follow-up study.

CONCLUSIONS

An enlarged spleen in febrile females undergoing CT in the puerperium may reflect physiological changes occurring during pregnancy.