Splenic rupture as a complication of colonoscopy.

Splenic rupture is a rare but potentially lethal complication of colonoscopy. We report a 66-year-old man who developed abdominal pain 6 hours after diagnostic colonoscopy. His clinical status deteriorated rapidly. Splenic rupture was identified at laparotomy. He recovered after surgery.     

Splenic rupture following colonoscopy: an unusual complication]

A case of splenic rupture after an uneventful diagnostic colonoscopy in a 68-year old man is reported. Conservative management of this complication was successful. Splenic rupture is a unique and severe complication of colonoscopy, which can rarely be managed conservatively.     

Splenic injury as a complication of colonoscopy and polypectomy

Injury to the spleen is a rare complication of colonoscopy and polypectomy. The danger of this unusual complication is real and its early recognition and proper management are essential to a favorable outcome. A case of injury to the spleen requiring splenectomy following colonoscopy and polypectomy is reported and discussed. Review of the literature by the authors revealed only six similar cases.     

Splenic trauma: an unusual complication of colonoscopy with polypectomy

Nowadays, colonoscopy has become an invaluable tool in the diagnosis and treatment of diseases of the colon and rectum. Colonoscopy is still an invasive exam with several complications. The most common complications are perforation and bleeding, which occur in up to 1% after diagnostic colonoscopy and 3% of patients undergoing therapeutic colonoscopy. Less common complications include pneumothorax, pneumomediastinum, colonic volvulus, hernia incarceration, retroperitoneal abscess and mesenteric tear. Splenic rupture is a rare and potentially lethal colonoscopic complication with less than 45 cases reported in the world. The overall incidence is 0.004%. Mechanisms of injury and available treatment options remain discussed. We present a case of splenic rupture after colonoscopy with polypectomy in a 73-year-old woman managed first with nonoperative treatment and nine days later with surgical treatment. As the indications for colonoscopy expand, including the introduction of mass screening for colorectal cancer, endoscopists should be increasingly aware of that life-threatening complication after colonoscopy and know the emergency treatment.     

Acute appendicitis as a rare complication after colonoscopy

Complications due to colonoscopy are uncommon, and acute appendicitis is a very rare complication of colonoscopy. We present the case of an 83-year-old man who underwent colonoscopy and subsequently developed acute appendicitis. In patients with abdominal pain who have had a recent colonoscopy, a high index of suspicion is necessary for the accurate diagnosis of appendicitis. Colonoscopists should be aware of this rare complication and consider it when making a differential diagnosis of post-colonoscopy abdominal pain.     

Presacral hemorrhage: a rare complication of colonoscopy

The Authors describe a case of presacral hemorrhage after a colonoscopy in a patient taking anticoagulation. Surgical treatment was necessary to stop the hemorrhage.     

Splenic rupture at colonoscopy

We report splenic rupture a few hours after a colonoscopy. Even though the patient had no previous history of splenic injury or symptoms attributable to splenocolonic adhesions, exploration revealed adhesions between the spleen and the colon at the level of the splenic flexure. Pathological examination revealed capsular thickening and fibrosis. Splenocolonic adhesions may lead to potentially lethal rupture of the spleen. A careful history prior to endoscopy should rule out pathological conditions that may lead to formation of adhesions between the spleen and the colon. In addition, the endoscopist should consider splenic rupture after colonoscopy in the patient who develops abdominal pain and acute anemia without evidence of intestinal perforation or external bleeding.     

Splenic rupture following colonoscopy

Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insufflation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy.