Colonoscopy-induced Splenic Injury: Report of 3 Cases and Literature Review

Saad, Abdo; Rex, Douglas K.

doi:10.1007/s10620-007-9963-5

Cited by 46 publications

(25 citation statements)

References 53 publications

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“…Ultrasonography has been used successfully in some patients; however, it was not able to achieve such successful results as computerized tomography. Although plain abdominal radiography shows intraabdominal free air, it leads to delay in diagnosis, since it is unable to determine splenic damage and the amount of intraabdominal bleeding [11]. The most significant complaint of our patient after the procedure was abdominal pain.…”

Section: Discussionmentioning

confidence: 81%

Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy

et al. 2016

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Colonoscopy, which is routinely performed in diagnosis and treatment of colorectal disorders, is a reliable procedure. Its most frequent complications are bleeding and perforation. Splenic rupture is a very rarely met complication of colonoscopy, and delay in its diagnosis leads to increased morbidity and mortality. We presented a 69 years old female patient, who was diagnosed by computerized abdominal tomography, performed for her abdominal pain, which started following the colonoscopy. After 15 days of medical treatment and follow-up, laparoscopic splenectomy was performed one month after her colonoscopy. The patient was discharged on her 4 th postoperative day, with uneventful recovery. In patients who have complaint of abdominal pain following colonoscopy, an intraabdominal pathological condition should be considered and computerized abdominal tomography should be performed. If there is no detected intraperitoneal bleeding, in other words, if there is a sub-capsular hematoma of the spleen, medical management by monitoring the vital signs may be preferred. Then, splenectomy should be performed at an appropriate time. Keywords: Laparoscopy, splenectomy, colonoscopy ÖzKolonoskopi kolorektal hastalıkların tanı ve tedavisinde rutin olarak yapılan güvenilir bir işlemdir. En sık görülen komplikasyonlar kanama ve perforasyondur. Dalak rüptürü ise oldukça nadir görülen bir durumdur. Tanıda gecikme morbidite ve mortalitiye artırır. Biz 69 yaşında bir bayan hastayı sunduk. Kolonoskopi sonrası başlayan karın ağrısı şikayeti olan hastaya çekilen batın tomografisi ile tanı konuldu. On beş gün süreyle medikal tedavi uygulanan ve takip edilen hastaya kolonoskopiden 1 ay sonra laparaskopik splenektomi yapıldı. Ameliyat sonrası bir patoloji olmayan hasta 4. gün taburcu edildi. Kolonoskopi sonrası karın ağrısı oluşan hastalarda batın içi bir patoloji olabileceği düşü-nülerek batın tomografisi yapılmalı. Eğer periton içi bir kanama yoksa yani dalakta subkapsüler bir hematom var ise vital bulgu takibi ile medikal tedavi yapılabilir. Daha sonra hastaya uygun zamanda splenektomi yapılmalıdır.

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Section: Discussionmentioning

confidence: 81%

Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy

et al. 2016

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“…Its true incidence is very difficult to define [3,4] although in a recent single institution review by Kamath et al [5] of more than 296,000 colonoscopies in 18 years, SI occurred with an incidence of 0.001%. Since Wherry et al [6] described the first case of SI following a colonoscopy in 1974 just few case reports have been reported in the international literature along the last three decades up to a total of more than 65 cases [7,8].…”

Section: Discussionmentioning

confidence: 99%

Delayed presentation of splenic injury following diagnostic colonoscopy

et al. 2011

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Splenic injury (SI) is a rare complication after colonoscopy, but should be considered in the differential diagnosis of acute abdominal pain following this procedure. We report a case of delayed rupture and review pertinent literature. A 70-year-old patient on oral warfarin intake underwent colonoscopy that diagnosed obstructive rectal cancer and elongated colon conditioning the endoscope's passage. After 48 h, patient experienced sharp abdominal pain with mild peritoneal signs. Contrast-enhanced CT scan evidenced large amount of abdominal-free blood collection from grade II SI. Hypovolemic shock occurred following brief clinical observation. Urgent laparotomic splenectomy and contextual Hartmann's procedure were then carried out. Postoperative course was uneventful and definitive histology confirmed splenic subcapsular haematoma and locally advanced adenocarcinoma. Perforation and bleeding more likely occurred after colonoscopy, while few cases of SI are reported in literature since 1974. Traction on the splenocolic ligament and direct trauma has been advocated as possible causes. Peritoneal adhesions and splenic diseases usually are predisposing factors although not confirmed in our patient. Anticoagulant therapy favoured delayed filling up of subcapsular haematoma while bowel obstruction added further surgical challenge. Rapid onset of hemorrhagic shock required urgent splenectomy that remains the procedure of choice among the literature reviewed.

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“…Il faut rappeler que si un trauma splénique en cours d'EE gastrique n'a pas été précédemment décrit, il est bien connu qu'une lésion de la rate peut être la conséquence d'une simple colonoscopie au passage de l'angle gauche du côlon [6,7].…”

Section: Discussionunclassified

Hémorragie extraluminale suite à une échoendoscopie gastrique conventionnelle

Bonanno

G²,

Naso

et al. 2010

Acta Endosc

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Un homme de 75 ans a été examiné par échoendo-scopie gastrique suite à une douleur abdominale et à un ictère. À la fin de l'examen endoscopique, le patient présentait une intense douleur épigastrique. Le CT scanner a mis en évidence une plage de 7 cm, contenant un liquide dense, en arrière de la paroi postérieure de l'estomac et un aspect d'ischémie de la rate. Le drainage de la collection hématique, la cholécystecto-mie et la splénectomie ont été réalisés sept jours après l'examen diagnostique. L'hypothèse est qu'un passage difficile de l'échoendoscope à travers le pylore, secondaire à un phlegmon périvésiculaire, pourrait avoir causé la lésion d'un vaisseau splénique et donc un saignement extraluminal. Cette complication durant l'endoscopie conventionnelle n'a jamais été décrite auparavant. Mots clés Hémorragie extraluminale · Échoendoscopie · Douleur épigastrique · Cholécystectomie · SplénectomieAbstract A 75-year-old man underwent endoscopic ultrasound examination for abdominal pain and jaundice. At the end of the examination, the patient presented severe epigastric pain; CT scan showed a 7-cm area of dense liquid behind the posterior gastric wall and ischemia of the spleen. Splenectomy and cholecystectomy were carried out 7 days after the symptoms. It was hypothesized that a little difficulty of the passage of the echoendoscope through the pylorus could have caused a small injury of the splenic vessel determining the extraluminal bleeding. Extraluminal hemorrhage following a conventional endoscopic ultrasound examination has not been described previously.

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Colonoscopy-induced Splenic Injury: Report of 3 Cases and Literature Review

Cited by 46 publications

References 53 publications

Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy

Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy

Delayed presentation of splenic injury following diagnostic colonoscopy

Hémorragie extraluminale suite à une échoendoscopie gastrique conventionnelle

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