- start with the patient supine. (scanning the spleen with the patient decubitus often increases the risk of bowel gas and lung base obscuring the view)
- place your hand and the probe on the bed to visualise the spleen from a posterolateral approach.
- angle the probe between the ribs (intercostally).
- rotate the probe to be parallel to the rib space to maximise your window.
overlying bowel gas, overlying lung base or rib shadows can cause problems. to improve visualisaion, change rib spaces or slowly roll the patient,
try inspiration,expiration,distended abdomen,erect
rarely the left lobe of the liver (if enlarged) may be used as a window to assess the superoanterior portion of the spleen.
- if you can see the left kidney but cannot see the spleen, simply slide the probe superiorly.
- the most common mistake when beginning, is not being posterior enough.