Splenic rupture after diagnostic colonoscopy: a case report

Zenooz, Navid A.; Win, Thomas

doi:10.1007/s10140-006-0486-8

Cited by 20 publications

(9 citation statements)

References 7 publications

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“…Splenic rupture is an extremely uncommon complication of colonoscopy with an overall incidence of 0.004% [2] which is consistent with our observations; several mechanisms have been suggested, including direct trauma, excessive splenocolic ligament traction and decrease in the relative mobility between the spleen and the colon.…”

Section: Discussionsupporting

confidence: 78%

Splenic Rupture, Beyond and Behind: A Histological, Morphometric and Follow-Up Study of 254 Cases

Sterlacci

Heiss²,

Augustin³

et al. 2006

Pathobiology

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Objective: Population-based data regarding splenic rupture causes are sparse. To systematically characterize histology and morphometry of splenic rupture, we performed a retrospective clinicopathological study of 254 patients. Methods: Our electronic data base was reviewed and all splenic rupture cases were morphologically, morphometrically and, where needed, molecularly analyzed. Clinical and follow-up data were gained by reviewing patient charts. A formula to calculate splenic volume based on size was established and results were compared to the actual volumes. Results: Ruptured spleens presented 0.1% of all gross surgical pathology specimens. Nearly 90% were due to trauma and approximately 10% were pathologic, being associated with underlying diseases (5% with unexpected diseases) such as splenic angiomas, granulomatous diseases, infarctions, hepatopathies, cysts, hemorrhagic diatheses, hematological neoplasms, metastatic carcinoma and collagenosis. Men were more often affected than women. Morphometric analysis showed distinct splenic weights, volumes and capsule thicknesses with respect to the different rupture causes. Pathological ruptures were predominantly observed in elderly, male patients with larger spleens. Conclusions: Splenic rupture is due to an often unexpected underlying disease in approximately 10% of the cases. This should be kept in mind when dealing with susceptible patient groups.

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Section: Discussionsupporting

confidence: 78%

Splenic Rupture, Beyond and Behind: A Histological, Morphometric and Follow-Up Study of 254 Cases

Sterlacci

Heiss²,

Augustin³

et al. 2006

Pathobiology

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“…Further analysis also showed a splenectomy rate Nearly complete splenic capsular avulsion with evidence of diffuse hemorrhage from the surface of the spleen of 72.5%, which is signifi cantly higher than the rates previously reported (Table 1). 7,8,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Consequently, the traditional management principles of blunt splenic injury may not apply to the injuries sustained from colonoscopy. Splenic injuries after colonoscopy may be characterized by a higher grade of injury or necessitate earlier operative intervention, namely an open splenectomy.…”

Section: Discussionmentioning

confidence: 99%

Splenic rupture as a complication of colonoscopy: Report of a case

et al. 2009

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Colonoscopy is a common procedure with the rare complication of a splenic injury. The proposed mechanism of injury is excessive splenocolic ligament traction. The diagnosis is made by computed tomography and the treatment is determined by the patient's stability. Here we report a case of splenic injury during colonoscopy with failure to manage conservatively. A review of the literature and suggested guidelines are also provided.

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“…Only 40 cases have been reported [3][4][5][6][7][8][9][10][11][12][13][14][15] . To our knowledge, our case is the first case coming from South America.…”

Section: Discussionmentioning

confidence: 99%

“…There are also some reported cases with a late presentation (from more than 24 h to 10 d) and mild symptoms [5,6] . CT scan is the imaging modality of choice [11,12] , which determines the extent of splenic damage, and demonstration of hemoperitoneum. This information, added to the clinical setting, may help decide on the therapeutic option.…”

Section: Discussionmentioning

confidence: 99%

Splenic rupture following colonoscopy

Guerra

Francisco²,

Pimentel³

et al. 2008

WJG

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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.

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Splenic rupture after diagnostic colonoscopy: a case report

Abstract: Colonoscopy is a commonly used diagnostic and therapeutic procedure. Splenic injury or rupture after this procedure is rare. We report a case of splenic rupture and hematoma in a middle-aged man who presented with symptoms of worsened anemia after diagnostic colonoscopy.

Cited by 20 publications

References 7 publications

Splenic Rupture, Beyond and Behind: A Histological, Morphometric and Follow-Up Study of 254 Cases

Splenic Rupture, Beyond and Behind: A Histological, Morphometric and Follow-Up Study of 254 Cases

Splenic rupture as a complication of colonoscopy: Report of a case

Splenic rupture following colonoscopy

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