Severe splenic rupture after colorectal endoscopic submucosal dissection

Tejada, Alberto Herreros de; Giménez-Alvira, Luis; Brule, Enrique Van den; Sánchez-Yuste, Rosario; Matallanos, P; Blázquez, Esther Jiménez; Calleja, José Luís; Abreu, Luís

doi:10.3748/wjg.v20.i28.9618

Cited by 8 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…138 publications (7 case series and 131 singular case reports) were included of 163 individual patients treated primarily with splenectomy for splenic laceration after colonoscopy 11,14,15,17–19,31,33,34,40,42,45,50,52–176 . Individual patient data are shown in Supplementary Table and presented in comparison to SAE and splenorrhaphy in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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

Lukies,

Clements

2023

UEG Journal

View full text Add to dashboard Cite

BackgroundSplenic injury due to colonoscopy is rare, but has high mortality. While historically treated conservatively for low‐grade injuries or with splenectomy for high‐grade injuries, splenic artery embolisation is increasingly utilised, reflecting modern treatment guidelines for external blunt trauma. This systematic review evaluates outcomes of published cases of splenic injury due to colonoscopy treated with splenic artery embolisation.MethodsA systematic review was performed of published articles concerning splenic injury during colonoscopy treated primarily with splenic artery embolisation, splenectomy, or splenorrhaphy from 1977 to 2022. Datapoints included demographics, past surgical history, indication for colonoscopy, delay to diagnosis, treatment, grade of injury, splenic artery embolisation location, splenic preservation (salvage), and mortality.ResultsThe 30 patients treated with splenic artery embolisation were of mean age 65 (SD 9) years and 67% female, with 83% avoiding splenectomy and 6.7% mortality. Splenic artery embolisation was proximal to the splenic hilum in 81%. The 163 patients treated with splenectomy were of mean age 65 (SD 11) years and 66% female, with 5.5% mortality. Three patients treated with splenorrhaphy of median age 60 (range 59–70) years all avoided splenectomy with no mortality. There was no difference in mortality between splenic artery embolisation and splenectomy cohorts (p = 0.81).ConclusionsSplenic artery embolisation is an effective treatment option in splenic injury due to colonoscopy. Given the known benefits of splenic salvage compared to splenectomy, including preserved immune function against encapsulated organisms, low cost, and shorter hospital length of stay, embolisation should be incorporated into treatment pathways for splenic injury due to colonoscopy in suitable patients.

show abstract

Section: Resultsmentioning

confidence: 99%

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

Lukies,

Clements

2023

UEG Journal

View full text Add to dashboard Cite

show abstract

“…A total of 103 cases have been described in 75 reports [6]. Published articles estimate an incidence from 1 x 6,000 cases annually [9][10][11] to 1-21 × 100,000 annually [8,12], with a mortality rate of 5.4% [7,9,10,12,13]. Risk factors have been described predisposing spleen injury; those patient-dependent are: splenomegaly, adhesions between spleen and colon from prior surgery, neoplasm, inflammation such as diverticular disease, pancreatitis, inflammatory bowel disease, endometriosis and anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

Splenic Injury after Colonoscopy: Two Case Reports and Literature Review

Caraballo¹

2015

J Gastric Disord Ther

View full text Add to dashboard Cite

Background: Spleen injury is an uncommon life threatening complication after routine colonoscopy with a low incidence of 0.001%-0.004% approximately. There should be a high level of suspicion when patients that underwent a colonoscopy start presenting abdominal pain during the first 24 hours and are hemodynamically unstable.Method: Present two cases of splenic injury after routine colonoscopy and a brief literature review.Results: Two women arrived to the Emergency Department (ED) with abdominal pain four days after undergoing routine colonoscopy. Splenectomy was performed in one patient, and the other was admitted into the Intensive Care Unit (ICU), recovering satisfactorily. Both patients were discharged on the 6th day after admission without any further complications. Conclusion:The real incidence of splenic injury remains unknown, due to the reluctance to publish and the absence of guidelines. Many of splenic injuries don´t present symptoms, so they are not diagnosed and remain unrecognized.Most of the patients present symptoms in the first 24 hours. In patients with a late presentation, a high level of suspicion is advised in order to make a timely diagnosis.Diagnose is clinically based and confirmed with a Computer Tomography Scan (CT), considered the gold standard. Treatment should be based on the hemodynamic status of the patient.

show abstract

“…These patients are mainly female (71.5%) and have a mean age of 63 years as well as a previous history of abdominal surgery (50.8–65%) [ 1 ]. It is essential to identify this complication and to treat it as soon as possible, due to the elevated morbidity and mortality [ 3 , 4 ]. We present a case of a splenic rupture after screening colonoscopy resulting in splenectomy.…”

Section: Introductionmentioning

confidence: 99%

Splenic Trauma during Colonoscopy: The Role of Intra-Abdominal Adhesions

Chime

Ishak

Kumar

et al. 2018

Case Reports in Gastrointestinal Medicine

View full text Add to dashboard Cite

Splenic rupture following colonoscopy is rare, first reported in 1974, with incidence of 1–21/100,000. It is critical to anticipate splenic trauma during colonoscopy as one of the causes of abdominal pain after colonoscopy especially when located in the left upper quadrant or left shoulder. Postoperative adhesions is a predisposing factor for splenic injury, and management is either operative or nonoperative, based on hemodynamic stability and/or extravasation which can be seen on contrast-enhanced CT scan of the abdomen. We present a case of a splenic rupture after colonoscopy in a patient with splenocolic adhesions, requiring splenectomy as definite treatment.

show abstract

Severe splenic rupture after colorectal endoscopic submucosal dissection

Cited by 8 publications

References 9 publications

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

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

Splenic Injury after Colonoscopy: Two Case Reports and Literature Review

Splenic Trauma during Colonoscopy: The Role of Intra-Abdominal Adhesions

Contact Info

Product

Resources

About