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Splenic veins exit the spleen at the centrally located hilus and merge into the single large splenic vein deep to the spleen, which can be traced transversely across the abdomen to its junction with the portal vein. Color flow Doppler evaluation, if available, allows for additional evaluation of the splenic vein and its branches (see Figures 9.1AB, 9.2 and 39.8).

Pearl: The splenic capsule is hyperechoic (bright white) and its vessels cross the splenic capsule. In contrast, the hepatic capsule is not sonographically apparent and its vessels do not cross the hepatic capsule. This anatomical difference can be used to distinguish spleen from liver.