Splenic injury in colonoscopy: a review.
BACKGROUND
Splenic rupture secondary to colonoscopy was first reported in 1974 by Wherry and Zehner. It has an incidence of around 0.00005-0.017%, and a mortality rate of 5%.


METHODS
We performed a literature search to identify the demographic profile, risk factors, clinical presentations, diagnosis and management of this rare complication.


RESULTS
There were 66 patients (51 females and 14 males), with a median age of 65. The mortality rate was 4.5%. Majority (n=41, 62.1%) occurred in uneventful colonoscopies. Symptoms usually (74%) occurred within 24h, and 55.8% presented within 24h. Majority (93.9%) had some form of work-up done, with blood tests (78.8%) and CT (68.2%) being the most frequent. Laparotomy and splenectomy were done in over half (56.1%) of the patients. Splenic hematoma (47%), laceration (47%) and rupture (33.3%) were the most common findings.


CONCLUSIONS
Splenic injury is an important complication to be aware of as its number will continue to rise with the increasing numbers of colonoscopies being performed for colorectal diseases, and delayed diagnosis may result in adverse outcome for the patient.
Ha
Jennifer Fong
JF
Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands 6009, Western Australia, Australia. jenha81@yahoo.com.au
Minchin
David
D
D003113:Colonoscopy / Q000009:adverse effects*; D006801:Humans; D013156:Splenectomy; D013161:Splenic Rupture / Q000209:etiology* / Q000601:surgery