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Severe splenic rupture after colorectal endoscopic submucosal dissection
Alberto Herreros de Tejada1, Luis Giménez-Alvira1, Enrique Van den Brule1
1Alberto Herreros de Tejada, Pilar Matallanos, Esther Blázquez, Jose L Calleja, Luis E Abreu, Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, 28222 Madrid, Spain.
Splenic rupture (SR) is a rare complication after colonoscopy, particularly following endoscopic submucosal dissection (ESD). Awareness of this risk is crucial for endoscopists performing left-sided colorectal ESD procedures.
Area of Science:
- Gastroenterology
- Surgical Complications
Background:
- Splenic rupture (SR) is a rare but serious complication post-colonoscopy.
- Delayed diagnosis of SR can lead to increased morbidity and mortality.
- Loop formation and excessive torquing during colonoscopy may be risk factors for SR.
Observation:
- A 65-year-old woman developed severe hypotension 36 hours after undergoing endoscopic submucosal dissection (ESD) for a descending colon tumor.
- The patient was diagnosed with splenic rupture (SR).
Findings:
- The patient underwent a splenectomy and recovered without complications.
- This is the first reported case of splenic rupture (SR) following colorectal endoscopic submucosal dissection (ESD).
Implications:
- Colorectal ESD, especially in the left colon, is a lengthy and position-intensive procedure.
- Endoscopists performing colorectal ESD should be aware of the potential risk of splenic rupture (SR).
- Vigilance and prompt diagnosis are essential for managing this rare complication.
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