Splenic rupture following colonoscopy.
Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insufflation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy.
Guerra
Juan-Francisco
JF
Departamento de Cirugia Digestiva, Pontificia Universidad Catolica de Chile, Marcoleta 367, Santiago 8330024, Chile. jfguerra@uc.cl
San Francisco
Ignacio
I
Pimentel
Fernando
F
Ibanez
Luis
L
D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D013156:Splenectomy; D013161:Splenic Rupture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome