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Case Reports
. 2018 Jul 30:6:2050313X18791069.
doi: 10.1177/2050313X18791069. eCollection 2018.

A delayed presentation of splenic laceration and hemoperitoneum following an elective colonoscopy: A rare complication with uncertain risk factors

Allison N Zhang  1 , Jagannath M Sherigar  1 , Debra Guss  1 , Smruti R Mohanty  1
Affiliations
Case Reports

A delayed presentation of splenic laceration and hemoperitoneum following an elective colonoscopy: A rare complication with uncertain risk factors

Allison N Zhang et al. SAGE Open Med Case Rep. .

Abstract

Splenic laceration is a rare yet often underreported complication of colonoscopy that is infrequently discussed with the patient during the consent process. Most cases present within 48 h after the inciting colonoscopy; a delayed presentation is rare. We present a case of splenic laceration with hemoperitoneum that manifested 5 days after the initial colonoscopy. The patient was treated conservatively. Traditionally perceived risk factors such as intra-abdominal adhesions, splenomegaly, anticoagulation use, biopsy, polypectomy, a technically challenging procedure, and anesthesia assistance have not been clearly shown to increase the incidence of splenic injury following a colonoscopy. Since the risk factors of splenic injury remain unclear, the clinical presentation is nonspecific, and the consequences can be serious, the endoscopist should make an effort to inform the patient of this rare complication before the procedure.

Keywords: Splenic injury; colonoscopy complications; hemoperitoneum; splenic laceration.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Subcapsular splenic hematoma. The spleen (arrowhead) is displaced by high-density fluid (Hounsfield unit of 69, arrow) consistent with a loculated hematoma underneath the splenic capsule. (b) Splenic laceration. There is a linear defect in the spleen (arrow) measuring 1.2 cm in depth representing a splenic laceration. (c) Hemoperitoneum. There is free fluid (arrow) in the peritoneal cavity that displays a Hounsfield unit of 65 consistent with blood, in contrast to the fluid content of the bladder (arrowhead) which has a Hounsfield unit of 15.
See this image and copyright information in PMC

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