First report of splenic rupture following deep enteroscopy

Girelli, C.M.; Pometta, R.; Facciotto, C.; Mella, R.; Bernasconi, Giordano

doi:10.4253/wjge.v8.i9.391

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…[ 10 ] However, no such complication occurred in this study, suggesting that during enteroscopy through the mouth, the operator reduced the gas flow in the intestine to reduce the pressure in the intestinal tract. Splenic rupture following deep enteroscopy has also been reported,[ 11 ] but did not occur in this study; our experience showed that brute force should be avoided when the scope is being moved forward and backward.…”

Section: Discussionmentioning

confidence: 47%

Effect of Double-Balloon Enteroscopy on Diagnosis and Treatment of Small-Bowel Diseases

Tang

Huang

Cui

et al. 2018

Chinese Medical Journal

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Background:The diagnosis and treatment of small-bowel diseases is clinically difficult. The purpose of this study was to evaluate the diagnostic and therapeutic value of double-balloon enteroscopy in small-bowel diseases.Methods:The history and outcomes of 2806 patients who underwent double-balloon enteroscopy from July 2004 to April 2017 were reviewed, which included 562 patients with obscure digestive tract bleeding, 457 patients with obscure diarrhea, 930 patients with obscure abdominal pain, 795 patients with obscure weight loss, and 62 patients with obscure intestinal obstruction. Examinations were performed through the mouth and/or anus according to the clinical symptoms and abdominal images. If a lesion was not detected through one direction, examination through the other direction was performed as necessary. Eighty-four patients with small-bowel polyps, 26 with intestinal obstruction caused by enterolith, and 18 with bleeding from Dieulafoy's lesions in the small intestine were treated endoscopically.Results:A total of 2806 patients underwent double-balloon enteroscopy, and no serious complications occurred. An endoscopic approach through both the mouth and anus was used in 212 patients. Lesions were detected in 1696 patients, with a detection rate of 60.4%; the rates for obscure digestive tract bleeding, diarrhea, abdominal pain, weight loss, and intestinal obstruction were 85.9% (483/562), 73.5% (336/457), 48.2% (448/930), 49.1% (390/795), and 62.9% (39/62), respectively. For patients with small-bowel polyps who underwent endoscopic therapy, no complications such as digestive tract bleeding and perforation occurred. Intestinal obstruction with enteroliths was relieved with endoscopic lithotripsy. Among the 18 patients with bleeding from small-bowel Dieulafoy's lesions, 14 patients were controlled with endoscopic hemostasis.Conclusion:Double-balloon enteroscopy is useful for diagnosing and treating some small-bowel disease.

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Section: Discussionmentioning

confidence: 47%

Effect of Double-Balloon Enteroscopy on Diagnosis and Treatment of Small-Bowel Diseases

Tang

Huang

Cui

et al. 2018

Chinese Medical Journal

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“…138 publications (7 case series and 131 singular case reports) were included of 163 individual patients treated primarily with splenectomy for splenic laceration after colonoscopy 11,14,15,17–19,31,33,34,40,42,45,50,52–176 . Individual patient data are shown in Supplementary Table and presented in comparison to SAE and splenorrhaphy in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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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Splenectomy post-splenic injury following dilatation of Roux-en-y enterostomy stomal stricture: an unexpected complication

et al. 2021

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A 53-year-old woman presented in the early hours of the morning with generalised abdominal pain and features of hypovolaemic shock, following a dilatation of an enterostomy stricture 12 hours prior. Dilatation of this stricture was indicated by ongoing dysphagia, which had been successfully dilated twice before without incident. Standard resuscitative measures and confirmation of the endoscopically-caused splenic injury by CT scan were followed promptly by a splenectomy to control ongoing blood loss. The strictured enterostomy was revised to mitigate further need for endoscopic dilatation. The patient recovered well and was discharged shortly after on a soft diet.

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First report of splenic rupture following deep enteroscopy

Cited by 3 publications

References 16 publications

Effect of Double-Balloon Enteroscopy on Diagnosis and Treatment of Small-Bowel Diseases

Effect of Double-Balloon Enteroscopy on Diagnosis and Treatment of Small-Bowel Diseases

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

Splenectomy post-splenic injury following dilatation of Roux-en-y enterostomy stomal stricture: an unexpected complication

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