Splenic Rupture Diagnosed with Bedside Ultrasound in a Patient with Shock in the Emergency Department Following Colonoscopy

Mulkerin, William; Mitarai, Tsuyoshi; Gharahbaghian, Laleh; Perera, Phillips

doi:10.5811/westjem.2015.6.27548

Cited by 5 publications

(2 citation statements)

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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 ).…”

Section: Resultsmentioning

confidence: 99%

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

Lukies,

Clements

2023

UEG Journal

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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.

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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 ).…”

Section: Resultsmentioning

confidence: 99%

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

Lukies,

Clements

2023

UEG Journal

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A systematic review of splenic injuries during colonoscopies: Evolving trends in presentation and management

Jehangir

Poudel

Masand-Rai

et al. 2016

International Journal of Surgery

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Iatrogenic splenic injury: review of the literature and medico-legal issues

et al. 2016

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AbstractIntroductionIatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed to a technical error of the operator rather than being an unpredictable and unpreventable complication. It is important for the medico-legal expert to have great knowledge on iatrogenic splenic injuries because it is important to evaluate every step of the first procedure performed, how a splenic injury is produced, and whether the correct treatment for the splenic injury was administered in a judgment.

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Splenic Rupture Diagnosed with Bedside Ultrasound in a Patient with Shock in the Emergency Department Following Colonoscopy

Cited by 5 publications

References 5 publications

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

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

A systematic review of splenic injuries during colonoscopies: Evolving trends in presentation and management

Iatrogenic splenic injury: review of the literature and medico-legal issues

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