title: Splenic rupture following routine colonoscopy.
abstract: Splenic rupture is a life-threatening condition characterized by internal hemorrhage, often difficult to diagnose. Colonoscopy is a gold standard routine diagnostic test to investigate patients with gastrointestinal symptoms as well as to those on the screening program for colorectal cancer. Splenic injury is seldomly discussed during consent for colonoscopy, as opposed to colonic perforation, as its prevalence accounts for less than 0.1%. A 66-year-old Caucasian woman with no history of collagen disorder was electively admitted for routine colonoscopy for surveillance of adenoma. She was admitted following the procedure for re-dosing of warfarin, which was stopped prior to the colonoscopy. The patient was found collapsed on the ward the following day with clinical shock and anemia. Computed tomography demonstrated grade 4 splenic rupture. Immediate blood transfusion and splenectomy was required. Splenic rupture following routine colonoscopy is extremely rare. Awareness of it on this occasion saved the patient's life. Despite it being a rare association, the seriousness warrants inclusion in all information leaflets concerning colonoscopy and during its consent.
authors.affiliation: Department of Surgery, Russells Hall Hospital, Dudley, West Midlands, Warwick, UK.
authors.forename: Tabraze
authors.initials: T
authors.lastname: Rasul
authors.forename: Edmund
authors.initials: E
authors.lastname: Leung
authors.forename: Kirsten
authors.initials: K
authors.lastname: McArdle
authors.forename: Rajiv
authors.initials: R
authors.lastname: Pathak
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dalmia
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D013161:Splenic Rupture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D014859:Warfarin