The spleen (Read more!) is positioned in the left upper quadrant (left hypochondriac region) of the abdomen, lying posterolateral to the stomach. It is located between the fundus of the stomach and the left hemidiaphragm at the level of ribs nine to eleven.

• Medial and posterior to the spleen lies the left kidney (Read more!) and left adrenal gland (Read more!).
• In addition, the tail of the pancreas is found adjacent to the medial aspect of the spleen.
• Lateral to the spleen are the rib cage, phrenicocolic ligament, and the anterolateral abdominal wall muscles.
• The diaphragm (Read more!) is superior to it, while the left colic flexure (Read more!) is positioned inferior. Hence, the left colic flexure is also called the splenic flexure.

Usually, the spleen does not extend beyond the left costal arch, and it is not palpable in a healthy individual during physical examination. It can only be palpable if it extends beyond the left costal arch. In that case, an enlarged spleen is called splenomegaly.

Note: 10 to 30% of the population have an accessory spleen. An accessory or supernumerary spleen is a benign condition in which splenic tissue is found outside and separately from the spleen. Usually, a person has one to six accessory spleens. Their size can vary, but most often, they do not exceed 0.4 inches (1 centimeter). In most cases, the accessory spleen is found in the splenic hilum or near the tail of the pancreas. However, it can also be positioned within the gastrosplenic ligament or splenorenal ligament or the stomach wall, intestinal wall, greater omentum, mesentery, pelvis or even scrotum.