A Case of Iatrogenic Splenic Injury Following Routine Colonoscopy With Possible Influence of Unique Anatomy Due to Severe Scoliosis

Wright, Jacob B; Gray, Sanjiv; Huynh, Dustin

doi:10.7759/cureus.14352

Cited by 2 publications

(3 citation statements)

References 16 publications

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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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“…Conservative [ 13 ], percutaneous [ 14 ], and surgical strategies have been described in the literature [ 15 ]. Patients who are hemodynamically stable are generally managed conservatively with parenteral fluids, pain control, and serial monitoring of H&Hs, as in our case.…”

Section: Discussionmentioning

confidence: 99%

Splenic Injury: A Curious Complication of Colonoscopy

Suarez¹,

Hernandez²,

Diaz³

et al. 2023

Cureus

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Colonoscopies are generally considered a safe procedure with an overall complication rate of 0.5%. Splenic injuries, including laceration, subcapsular hematoma, and rupture, have been thought to be underreported in the currently available literature. The etiology of splenic injury remains unknown, although excessive splenocolic ligament stretching and traction of adhesions have been hypothesized to play a role in its development. Even though conservative, percutaneous, and surgical strategies have been described in the literature, these strategies have been associated with higher mortality, and there is no consensus on the optimal approach to management. We present the case of a patient who sustained a splenic injury after a colonoscopy and was successfully managed with conservative measures.

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A Case of Iatrogenic Splenic Injury Following Routine Colonoscopy With Possible Influence of Unique Anatomy Due to Severe Scoliosis

Abstract: Wright et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 2 publications

References 16 publications

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

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

Splenic Injury: A Curious Complication of Colonoscopy

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