Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2012 Sep;6(3):624-8.
doi: 10.1159/000343428. Epub 2012 Sep 28.

Laparoscopic splenectomy for traumatic splenic injury after screening colonoscopy

Salim Abunnaja  1 , Lucian Panait, J Alexander Palesty, Shady Macaron
Affiliations
Case Reports

Laparoscopic splenectomy for traumatic splenic injury after screening colonoscopy

Salim Abunnaja et al. Case Rep Gastroenterol. 2012 Sep.

Abstract

Colonoscopy is a widespread diagnostic and therapeutic procedure. The most common complications include bleeding and perforation. Splenic rupture following colonoscopy is rarely encountered and is most likely secondary to traction on the splenocolic ligament. Exploratory laparotomy and splenectomy is the most commonly employed therapeutic intervention for this injury reported in the literature. We present the case of a patient with this potentially fatal complication who was treated successfully at our institution. To our knowledge it is the first report in the literature of laparoscopic splenectomy as a successful minimally invasive treatment of splenic rupture following colonoscopy. The patient was a 62-year-old female who underwent screening colonoscopy with polypectomies at the cecum, descending colon and rectum. Immediately following the procedure she developed abdominal pain and had a syncopal episode. Clinical, laboratory and imaging findings were suggestive of hemoperitoneum and a ruptured spleen. A diagnostic laparoscopy was emergently performed and revealed a grade IV splenic laceration and hemoperitoneum. Laparoscopic splenectomy was completed safely and effectively. The patient's postoperative recovery was uneventful. We conclude that splenic rupture after colonoscopy is a rare but dangerous complication. A high index of suspicion is required to recognize it early. Awareness of this potential complication can lead to optimal patient outcome. Laparoscopic splenectomy may be a feasible treatment option.

Keywords: Colonoscopy; Laparoscopic splenectomy; Splenic injury.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cross section CT scan of the abdomen revealing hemoperitoneum and a ruptured spleen.
Fig. 2
Fig. 2
Coronal section CT scan of the abdomen revealing hemoperitoneum and a ruptured spleen.
Fig. 3
Fig. 3
Etiological mechanism: avulsion of the splenic capsule caused by excessive traction on the splenocolic ligament during the endoscopic examination and torque of the endoscope.
See this image and copyright information in PMC

References

    1. Castelli M. Splenic rupture: an unusual late complication of colonoscopy. CMAJ. 1986;134:916–917. - PMC - PubMed
    1. Olshaker JS, Deckleman C. Delayed presentation of splenic rupture after colonoscopy. J Emerg Med. 1999;17:455–457. - PubMed
    1. Volchok J, Cohn M. Rare complications following colonoscopy: case reports of splenic rupture and appendicitis. JSLS. 2006;10:114–116. - PMC - PubMed
    1. Wherry DC, Zehner H., Jr Colonoscopy-fiberoptic endoscopic approach to the colon and polypectomy. Med Ann Dist Columbia. 1974;43:189–192. - PubMed
    1. Skipworth JR, Raptis DA, Rawal JS, et al. Splenic injury following colonoscopy – an underdiagnosed, but soon to increase, phenomenon? Ann R Coll Surg Engl. 2009;91:W6–W11. - PMC - PubMed

Publication types