Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy

Abstract

Colonoscopy, which is routinely performed in diagnosis and treatment of colorectal disorders, is a reliable procedure. Its most frequent complications are bleeding and perforation. Splenic rupture is a very rarely met complication of colonoscopy, and delay in its diagnosis leads to increased morbidity and mortality. We presented a 69 years old female patient, who was diagnosed by computerized abdominal tomography, performed for her abdominal pain, which started following the colonoscopy. After 15 days of medical treatment and follow-up, laparoscopic splenectomy was performed one month after her colonoscopy. The patient was discharged on her 4(th) postoperative day, with uneventful recovery. In patients who have complaint of abdominal pain following colonoscopy, an intraabdominal pathological condition should be considered and computerized abdominal tomography should be performed. If there is no detected intraperitoneal bleeding, in other words, if there is a sub-capsular hematoma of the spleen, medical management by monitoring the vital signs may be preferred. Then, splenectomy should be performed at an appropriate time.

Keywords: Laparoscopy; colonoscopy; splenectomy.

Figure 1.

Unenhanced axial abdominal CT scan prior to colonoscopy: Spleen monitored with normal size and homogeneous parenchymal structure. Spleen integrity is normal. CT: computed tomography.

Figure 2.

Contrasted CT image of abdomen after one week of the colonoscopy: A hematoma, which has an average density of 10 HU and limited with spleen capsule, is observed. CT: computed tomography.

Figure 3.

Contrasted CT image of abdomen after three weeks of the colonoscopy: Hematoma has a tendency to become chronic and its average density was measured as 3 HU. CT: computed tomography.