title: Rare complications following colonoscopy: case reports of splenic rupture and appendicitis.
abstract: BACKGROUND
  Appendicitis and splenic rupture are 2 rare complications of colonoscopy reported in the literature. To our knowledge splenic rupture following colonoscopy has been reported 17 times in the English-language literature and is associated with excess traction on the splenocolic ligament. Appendicitis after colonoscopy has been reported only 9 times and is usually associated with obstruction of the appendiceal lumen with fecal matter during colonoscopy.
  
  
  METHODS
  We present the case reports of 2 patients: a 76-year-old woman who presented in consultation 24 hours after a routine colonoscopy with massive hemoperitoneum secondary to splenic rupture, seen on computed tomographic (CT) scan, who then underwent splenectomy; the second, a 60-year-old male who presented to the emergency room 16 hours after colonoscopy with clinical and computed tomographic scan findings of acute appendicitis who underwent a laparoscopic appendectomy.
  
  
  RESULTS
  Treatment of both patients resulted in resolution of their complications, splenic rupture and appendicitis. They both had an uneventful postoperative course and are doing well several months postoperatively.
  
  
  CONCLUSIONS
  We report 2 rare complications of colonoscopy, splenic rupture and appendicitis. In the setting of a recent colonoscopy and abdominal pain, a high index of suspicion is needed for their diagnosis.
authors.affiliation: Department of Surgery University of Massachusetts Medical School at Berkshire Medical Center, Pittsfield, Massachusetts 01201, USA. jvolchok@bhs1.org
authors.forename: Japa
authors.initials: J
authors.lastname: Volchok
authors.forename: Michael
authors.initials: M
authors.lastname: Cohn
mesh_terms: D000368:Aged; D001064:Appendicitis / Q000209:etiology*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013161:Splenic Rupture / Q000209:etiology*