Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 7, 2008; 14(41): 6410-6412
Published online Nov 7, 2008. doi: 10.3748/wjg.14.6410
Splenic rupture following colonoscopy
Juan Francisco Guerra, Ignacio San Francisco, Fernando Pimentel, Luis Ibanez
Juan Francisco Guerra, Ignacio San Francisco, Fernando Pimentel, Luis Ibanez, Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 8330024, Chile
Author contributions: Guerra JF designed the paper, collected and analyzed the data and wrote the manuscript; San Francisco I collect the data and reviewed the manuscript; Pimentel F and Ibanez L approved the final version of the manuscript.
Correspondence to: Juan Francisco Guerra, Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 8330024, Chile. jfguerra@uc.cl
Telephone: +56-2-3543870 Fax: +56-2-6382793
Received: April 9, 2008
Revised: October 14, 2008
Accepted: October 21, 2008
Published online: November 7, 2008
Abstract

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.

Keywords: Colonoscopy; Splenic injury; Splenic rupture; Splenectomy