The mean vertebral level for men was 8.88, equating to the inferior half of the T11 vertebral body (range: 1–17 ), and 11.36 for women, equating to the inferior half of the T12 vertebral body (range: 4–16 ). The mean ages of male and female subjects were 68.1 years and 66.7 years respectively ( p=0.630). There was an even distribution between male and female patients (50:50). The distances from the midline (middle of the posterior aspect of the vertebral body) to the outermost aspect of the flexure and to the adjacent lateral abdominal wall were measured ( Figs 2 and and3 3). The vertebrae were divided into three sections: superior half of body, inferior half of body and intervertebral disc ( Fig 1). The vertebral level (ie the height of the splenic flexure) is defined by the section of the vertebra to which the splenic flexure corresponds. 4 Essentially, the axial and coronal views provided on picture archiving and communication system workstations for CT interpretation are compared. The method of anatomically siting the splenic flexure has been described in a previous paper and was found to be highly reproducible among observers. All patients underwent CT in the supine position with 2mm slice thickness. Patients who had undergone previous gastrointestinal surgery and those undergoing CT colonography were excluded to avoid artificially altered anatomy. Portal venous CT of 100 patients (50 male, 50 female) undergoing preoperative imaging for colorectal malignancy was analysed. All patients received a standardised volume of intravenous contrast and imaging acquired in the portal venous phase. It was defined as the most superior and lateral aspect of the transverse colon in relation to the splenic hilum on CT.ĬT was performed in the supine position with the patient in deep inspiration. For the purpose of this study, the radiological definition of what constituted the splenic flexure was agreed on by a consultant radiologist and the lead investigator. Operatively, we define it as the section of the transverse colon that lies at the splenic hilum and deviates inferiorly along the lateral abdominal wall. This is true for operative as well as radiological identification. There is no universally accepted definition of what constitutes the splenic flexure.
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