Splenic Rupture as a Complication of Colonoscopy

Abstract

Splenic rupture is a rare but serious complication after colonoscopy, with high global mortality (5%). Diagnosis requires a high index of suspicion because presentation can be subtle, nonspecific, and delayed from hours to days and then not easily attributed to a recent endoscopy. Urgent splenectomy is the most common treatment option. A 73-year-old woman was admitted to the emergency department 8 h following a diagnostic colonoscopy. She presented abdominal pain and syncope. The diagnosis of splenic rupture was made and a splenectomy was urgently performed. The patient's postoperative recovery was uneventful. Splenic rupture is a rare complication of colonoscopy which cannot be underestimated in the differential diagnosis of abdominal pain after this procedure. Splenic injuries may occur in apparently uncomplicated, easy colonoscopies performed by experienced endoscopists, with no risk factors identified, as in this case.

Iatrogenic Severe Splenic Injury after Colonoscopy

“…Splenic injury is a rare complication of colonoscopy [ 1 – 3 , 5 – 10 ]. The symptoms associated with postcolonoscopy splenic injury are nonspecific, and there is significant variability in the timing of onset of symptoms [ 1 ]; hence, it poses a diagnostic dilemma for clinicians [ 4 ].…”

“…Colonoscopy is a low-risk procedure for screening, diagnostic, and therapeutic purposes [ 1 ]. Bleeding and colonic perforation are the most commonly described complications following colonoscopy [ 1 – 3 ].…”

“…Colonoscopy is a low-risk procedure for screening, diagnostic, and therapeutic purposes [ 1 ]. Bleeding and colonic perforation are the most commonly described complications following colonoscopy [ 1 – 3 ]. Splenic injury is also a complication of colonoscopy, with only about 100 reported cases worldwide, making it a rare complication of colonoscopy [ 1 , 2 ].…”

“…Bleeding and colonic perforation are the most commonly described complications following colonoscopy [ 1 – 3 ]. Splenic injury is also a complication of colonoscopy, with only about 100 reported cases worldwide, making it a rare complication of colonoscopy [ 1 , 2 ]. Here, we present a patient who developed significant splenic injury (grade III) [ 4 ] with hemoperitoneum as a complication of diagnostic colonoscopy.…”

Splenic Rupture following Transnasal Endoscopy

“…After 2 weeks, he underwent endoscopic ultrasonography with fine-needle aspiration of the mediastinal mass, which was inconclusive. He later suffered a cardioembolic stroke and eventually died from a hospital-acquired pneumonia.Splenic rupture is a rare but increasingly recognized complication of colonoscopy [1]. Its occurrence following upper endoscopy is even rarer, with very few cases reported in the literature [2][3][4][5].…”