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Severe splenic rupture after colorectal endoscopic submucosal dissection
Authors:Alberto Herreros de Tejada  Luis Giménez-Alvira  Enrique Van den Brule  Rosario Sánchez-Yuste  Pilar Matallanos  Esther Blázquez  Jose L Calleja  Luis E Abreu
Abstract:Splenic rupture (SR) after colonoscopy is a very rare but potentially serious complication. Delayed diagnosis is common, and may increase morbidity and mortality associated. There is no clear relation between SR and difficult diagnostic or therapeutic procedures, but it has been suggested that loop formation and excessive torquing might be risk factors. This is a case of a 65-year-old woman who underwent endoscopic submucosal dissection (ESD) for lateral spreading tumor in the descending colon, and 36 h afterwards presented symptoms and signs of severe hypotension due to SR. Standard splenectomy was completed and the patient recovered uneventfully. Colorectal ESD is usually a long and position-demanding technique, implying torquing and loop formation. To our knowledge this is the first case of SR after colorectal ESD reported in the literature. Endoscopists performing colorectal ESD in the left colon must be aware of this potential complication.
Keywords:Splenic rupture   Endoscopic submucosal dissection   Colorectal neoplasm   Colonoscopy   Splenectomy
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