Splenic injury in colonoscopy: a review

Area of Science:

• Gastroenterology
• Surgical Complications
• Diagnostic Imaging

Background:

• Splenic rupture post-colonoscopy, first reported in 1974, occurs in 0.00005-0.017% of cases with a 5% mortality rate.
• This rare complication necessitates awareness due to its potential severity.

Purpose of the Study:

• To review the literature on splenic injury following colonoscopy.
• To identify demographic profiles, risk factors, clinical presentations, and management strategies for this complication.

Main Methods:

• A comprehensive literature search was conducted.
• Data on patient demographics, procedural details, clinical course, diagnostic work-up, and treatment were extracted and analyzed.

Main Results:

• The study identified 66 cases (77% female, median age 65), with a 4.5% mortality rate.
• Most injuries (62.1%) occurred during uneventful colonoscopies, with symptoms typically presenting within 24 hours.
• Diagnostic work-up frequently involved blood tests and CT scans, and over half of patients required laparotomy and splenectomy.

Conclusions:

• Splenic injury is an under-recognized complication of colonoscopy.
• Increasing colonoscopy rates for colorectal disease screening will likely lead to more cases.
• Prompt diagnosis and management are essential to improve patient outcomes.