title: Severe splenic rupture after colorectal endoscopic submucosal dissection.
abstract: Splenic rupture (SR) after colonoscopy is a very rare but potentially serious complication. Delayed diagnosis is common, and may increase morbidity and mortality associated. There is no clear relation between SR and difficult diagnostic or therapeutic procedures, but it has been suggested that loop formation and excessive torquing might be risk factors. This is a case of a 65-year-old woman who underwent endoscopic submucosal dissection (ESD) for lateral spreading tumor in the descending colon, and 36 h afterwards presented symptoms and signs of severe hypotension due to SR. Standard splenectomy was completed and the patient recovered uneventfully. Colorectal ESD is usually a long and position-demanding technique, implying torquing and loop formation. To our knowledge this is the first case of SR after colorectal ESD reported in the literature. Endoscopists performing colorectal ESD in the left colon must be aware of this potential complication.
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Alberto
authors: A
authors: Herreros de Tejada
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Luis
authors: L
authors: Giménez-Alvira
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Enrique
authors: E
authors: Van den Brule
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Rosario
authors: R
authors: Sánchez-Yuste
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Pilar
authors: P
authors: Matallanos
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Esther
authors: E
authors: Blázquez
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Jose L
authors: JL
authors: Calleja
authors: Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
authors: Luis E
authors: LE
authors: Abreu
mesh_terms: D000368:Aged; D001706:Biopsy; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012720:Severity of Illness Index; D013156:Splenectomy; D013161:Splenic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Colonoscopy; Colorectal neoplasm; Endoscopic submucosal dissection; Splenectomy; Splenic rupture