Splenic rupture after colonoscopy

Splenic rupture as a complication of colonoscopy: Report of a case

“…Further analysis also showed a splenectomy rate Nearly complete splenic capsular avulsion with evidence of diffuse hemorrhage from the surface of the spleen of 72.5%, which is signifi cantly higher than the rates previously reported (Table 1). 7,8,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Consequently, the traditional management principles of blunt splenic injury may not apply to the injuries sustained from colonoscopy. Splenic injuries after colonoscopy may be characterized by a higher grade of injury or necessitate earlier operative intervention, namely an open splenectomy.…”

Colonoscopic Splenic Injuries: Incidence and Management

“…34 Review of the case reports identified 59% of patients sustaining an iatrogenic splenic injury from colonoscopy had a history of prior abdominal surgery, but from our study, just two of the seven patients had prior history of abdominal surgeries. [3][4][5][6][7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][26][27][28]34,35 Others have proposed underlying splenic pathology (specifically splenomegaly, anticoagulant medications, and pharmacologic treatment such as hematopoietic growth factors) as possible risk factors; again, this was not borne out by our series: no patients in our series had underlying splenic pathology or were receiving hematopoietic agents. 33,34 Conclusion Splenic injury after colonoscopy is a very rare but potentially life-threatening complication of colonoscopy; patients usually present in an acute fashion with signs and symptoms of hemorrhagic shock.…”

Colonoscopy-induced Splenic Injury: Report of 3 Cases and Literature Review

“…Of the 25 cases that were found to have hemoperitoneum on US, CT scan or paracentesis upon presentation [5, 7, 11, 15, 17, 20, 22-26, 37, 46, 48, 51, 53, 55, 61, 64, 2 reported cases], 10 developed hypovolemic shock after first having a normal blood pressure [5,7,17,20,22,25,37,48,51,61]. Thus, the presence of free peritoneal fluid in a patient who presents with abdominal pain after colonoscopy indicates the need for close observation.…”

“…Of the 61 cases with reported hemodynamic status, 34 (56%) cases were unstable: 21 were unstable at presentation [8, 12-14, 18-21, 27, 28, 33, 34, 47, 49, 52, 56, 60, 62, 63, 65] and 13 became hemodynamically unstable after their presentation [5,7,9,17,20,22,25,37,48,51,57,61]. The average hemoglobin drop (mean ± SD = 3.77 ± 0.92 g/dl, n = 12) [12, 14, 19-21, 33, 34, 49, 52, 60, 63, 65] in the cases that were hemodynamically unstable at presentation was similar to the drop seen in the cases that were stable at presentation (3.64 ± 2.16 g/dl, n = 21, P [ 0.05) [5, 9, 11, 16, 17, 19, 22-25, 29, 36, 37, 46, 50, 51, 53, 58, 2 cases reported in this paper].…”

“…Twelve of 44 (27%) were splenectomized prophylactically in the absence of hemodynamic compromise (Table 4) [11,16,20,23,24,26,30,32,36,38,46,59], and in four operated patients the hemodynamic status was uncertain based on our review [4,6,10,74]. One case was splenectomized for the treatment of recurrent hemorrhagic splenic cyst after percutaneous drainage [6].…”