Spleen size in patients with inflammatory bowel disease. Does it have any clinical significance?

The finding that splenic atrophy is associated with a high complication rate in colitis has led to a long-term, prospective study of spleen size in inflammatory bowel disease. The spleen has been measured in 116 patients undergoing laparotomy for inflammatory bowel disease--80 Crohn's disease and 36 ulcerative colitis--from 1975 to 1985. Small spleen size, of lesser degree than that of classic splenic atrophy, is associated with presurgery disease complications as well as infective problems after surgery. Spleen size was not related to site or extent of disease, or to recurrence, but the wide range of spleen size seen in inflammatory bowel disease, comparable to that seen in malignancy suggests that more sophisticated tests of splenic function might show a closer correlation with disease patterns.