Splenic Rupture following Transnasal Endoscopy

First splenic rupture following an endoscopic esophageal myotomy: A case report

“…Moreover, no gastric pushing with the endoscope during the intervention was necessary and, despite the relatively long-time procedure, carbon dioxide insufflation significantly prevented distension. While all the other reported cases of splenic rupture following an upper endoscopy splenic rupture occurred immediately after the procedure[ 3 , 5 - 9 ], the latency for the onset of symptoms may share some similarity to the delayed splenic rupture that occurs after colonoscopy[ 4 , 11 ] or trauma[ 12 ].…”

“…Three cases of splenic laceration have previously been described after esophageal procedures and manipulation. A case of splenic injury was reported after placing a feeding tube through an extrinsic, probably neoplastic, stenosis of the middle esophagus using a 5.2 mm-gastroscope[ 9 ]. A second case of a splenic rupture was described after bougienage through a neoplastic stenosis at the GEJ[ 8 ].…”

“…However, this could not have been the cause in our case as we did not experience any unusual or specific difficulty during the procedure. Nevertheless, manipulation at the GEJ seems to be a constant adjunct to the mechanism of splenic injury[ 7 - 9 ].…”

“…Only two cases of splenic rupture after gastroscopy[ 5 , 6 ], and three cases following esophageal endoscopic procedures[ 7 - 9 ] have been reported in the literature since the advent of flexible endoscopes. However, there has been no report of splenic rupture after endoscopic myotomy for achalasia of the esophagus.…”