Splenic Rupture after Colonoscopy

Abstract

Colonoscopy is the gold standard in diagnosis of colorectal diseases. It is generally a safe procedure with low complication rate. Splenic rupture is a very rare complication of colonoscopy. The case presented here, is a 57 years old male patient with complaint of hematochesia. He had colonoscopy and diagnosed as sigmoid colon tumor. After colonoscopy he had the findings of acute abdomen. At the operation splenic rupture was detected and he had undergone splenectomy with subtotal colectomy for the sigmoidal tumor. Splenic rupture is very rare but fatal complication of colonoscopy. In the management of patients with post-colonoscopy abdominal pain splenic injury should be kept in mind.

Keywords

• Splenic rupture, colonoscopy, complication

Splenic Rupture after Colonoscopy

Öz

Kolonoskopi, Kolorektal hastalıkların tanısında, düşük kmlikasyon oranına sahip ve güvenli olmasıyla altın standart yöntem olarak kabul edilmektedir. Dalak rüptürü kolonoskopinin nadir bir komplikasyonu olarak bildirilmektedir. Burada sunulan hasta, 57 yaşında hematokezya şikayeti olan bir erkek hastadır. Hastaya yapılan kolonoskopide sigmoid kolonda tümöral lezyon tespit edildi. Kolonoskopi sonrası akut batın bulguları gözlenen hasta ameliyata alındı. Ameliyatta, dalak rüptürü tespit edilerek, hastaya subtotal kolektomi ve splenektomi yapıldı. Dalak rüptürü kolonoskopiye bağlı nadir görülen ancak ölümcül bir komplikasyondur. Kolonoskopi sonrası karın ağrısı olan hastalarda dalak rüptürü olabileceği akılda tutulmalıdır

Anahtar Kelimeler

• Dalak rüptürü, kolonoskopi, komplikasyon

References

1. Castelli M: Splenic rupture: an unusual late complication of colonoscopy CMAJ 1986;134:916–7.
2. Levine E, Wetzel LH. Splenic trauma during colonoscopy. AJR Am J Roentgenol 1987;149(5):939–40.
3. Tuso P, McElligott J, Marignani P. Splenic rupture at colo- noscopy. J Clin Gastroenterol 1987;9(5):559–62.
4. Prowda JC, Trevisan SG, Lev-Toaff AS. Splenic injury after colonoscopy: conservative management using CT. AJR Am J Roentgenol 2005;185(3):708–10.
5. Daniel Murariu, Sarah Takekawa, Nancy Furumoto. Splenic Rupture: A Case of Massive Hemoperitoneum Following Therapeutic Colonoscopy. Hawai‘i Med J 2010;69:140-1
6. Singla S, Keller D, Thirunavukarasu P, Tamandl D, Gupta S, Gaughan J, Dempsey D. Splenic injury during colonos- copy-a complication that warrants urgent attention. J Gastrointest Surg 2012;16(6):1225-34
7. Volchok J, Cohn M. Rare complications following colonos- copy: case reports of splenic rupture and appendicitis. J Soc Laparoendosc Surg 2006; 10: 114–6.
8. Ahmed A, Eller PM, Schiffman FJ. Splenic rupture: an unusual complication of colonoscopy. Am J Gastroenterol 1997; 92: 1201–4.

9. Di Lecce F, Vigano P, Pilati S, Mantovani N, Togliani T, Pulica C. Splenic rupture after colonoscopy. A case report and review of the literature. Chir Ital 2007;59:755–7.
10. Wherry DC, Zehner H Jr. Colonoscopic fiberoptic colono- scopic approach to the colon and polypectomy. Med Ann C 1974;43:189–92. Sevinc et al.
11. Eur J Gen Med 2014;11(3): 203-205 205