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
. 2023 Apr:105:108044.
doi: 10.1016/j.ijscr.2023.108044. Epub 2023 Mar 23.

Hemoperitoneum after routine colonoscopy: A case report

Remy Amory  1 , Yannick Nijs  2
Affiliations
Case Reports

Hemoperitoneum after routine colonoscopy: A case report

Remy Amory et al. Int J Surg Case Rep. 2023 Apr.

Abstract

Introduction and importance: Colonoscopy is a routine examination which is considered a safe and low risk procedure. Hemoperitoneum due to a splenic injury after colonoscopy is a rare but life-threatening complication.

Case presentation: We present the case of a 57-year-old woman without medical or surgical history who presented acute abdominal pain after a colonoscopy with three polypectomies. Clinical, biological investigations and imaging were suggestive for a hemoperitoneum. An emergency exploratory laparoscopy revealed a massive hemoperitoneum due to 2 avulsions of the splenic capsule.

Clinical discussion: We review the literature on incidence, mechanisms, risk factors, common symptoms, diagnosis methods and therapeutic options concerning hemoperitoneum due to a splenic injury after colonoscopy.

Conclusion: The early suspicion of this potential complication is the key to good care in this situation.

Keywords: Colonoscopy; Hemoperitoneum; Splenic injury.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest None.

Figures

Figs. 1
Figs. 1
A–B–C: Abdominal CT scan without intravenous contrast: presence of free fluid (red star) from the splenorenal recessus to the pelvis. D: Per-operative picture of the splenic capsular effraction (yellow arrow).
Fig. 2
Fig. 2
Spleen, colon, pancreas, diaphragm, splenocolic ligament, phrenosplenic ligament, pancreaticosplenic ligament, gastrosplenic ligament with short vessels. (Illustration based on the anatomy course of Professor B. Lengelé in Université catholique de Louvain, Faculty of Medicine.)
See this image and copyright information in PMC

References

    1. Colin J., et al. Une complication rare de la coloscopie. Rev Med Interne. 2020;j.revmed.2020.05.009:784–785. - PubMed
    1. Chukmaitov A., Bradley C.J., Dahman B., et al. Association of polypectomy techniques, endoscopist volume, and facility type with colonoscopy complications. Gastrointest. Endosc. 2013;77:436. - PMC - PubMed
    1. Piccolo G., Di Vita M., Cavallaro A., Zanghì A., Lo Menzo E., Cardì F., Cappellani A. Presentation and management of splenic injury after colonoscopy: a systematic review. Surg. Laparosc. Endosc. Percutan. Tech. 2014 Apr;24(2):95–102. doi: 10.1097/SLE.0b013e3182a83493. PMID: 24686342. - DOI - PubMed
    1. Ha J.F., Minchin D. Splenic injury in colonoscopy: a review. Int. J. Surg. 2009;7:424–427. - PubMed
    1. Zhang A.N., Sherigar J.M., Guss D., Mohanty S.R. A delayed presentation of splenic laceration and hemoperitoneum following an elective colonoscopy: A rare complication with uncertain risk factors. SAGE Open Med Case Rep. 2018;6 doi: 10.1177/2050313X18791069. 2050313X18791069. PMID: 30083323; PMCID: PMC6066810. - DOI - PMC - PubMed

Publication types