Hemoperitoneum with Splenic Artery Rupture Following Diagnostic Colonoscopy

Abstract

Colonoscopy is a safe and extremely popular diagnostic and therapeutic procedure. The most common complications are bleeding and perforation. Hemoperitoneum is a rare complication after a colonoscopy and is usually associated with splenic injury or solid organ pathology. This is potentially serious and can be life threatening. With the increasing number of colonoscopies performed, there has also been an increasing trend in reports of rare complications, such as pneumothorax, pneumomediastinum, appendicitis, small bowel perforation, septicemia, mesenteric tear, retroperitoneal abscess, and hemoperitoneum. This paper reports a unique case of hemoperitoneum after a recent colonoscopy without a splenic rupture or intra-abdominal abnormality, or external trauma. Most hemoperitoneum occurs within 48 hours after the inciting colonoscopy. In the present case, however, hemoperitoneum appeared 10 days after the colonoscopy. This case emphasizes that physicians should consider hemoperitoneum in a differential diagnosis of abdominal pain in patients after colonoscopy.

Splenic artery embolisation for splenic injury during colonoscopy: A systematic review

“…23 publications (5 case series of two or more patients and 18 singular case reports) were included of 30 individual patients primarily treated with splenic artery embolisation for splenic laceration after colonoscopy 27,30–51 . Individual patient data are shown in Supplementary Table and presented in comparison to splenectomy and splenorrhaphy in Table 1.…”

“…23 publications (5 case series of two or more patients and 18 singular case reports) were included of 30 individual patients primarily treated with splenic artery embolisation for splenic laceration after colonoscopy. 27 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 Individual patient data are shown in Supplementary Table S1 and presented in comparison to splenectomy and splenorrhaphy in Table 1 . Most patients were asymptomatic and a only a minority (20%) of colonoscopies were interventional, including biopsy or polypectomy (Supplementary Table S1 ).…”