Splenic rupture as an endoscopic complication: as rare as it appears?

Area of Science:

• Gastroenterology
• Cardiology
• Radiology

Background:

• An 86-year-old male with cardiovascular comorbidities, including anticoagulated atrial fibrillation, presented with acute lower gastrointestinal bleeding and anemia.
• Colonoscopy was performed to investigate the bleeding, revealing small angiodysplasias in the cecum.

Observation:

• Hours post-colonoscopy, the patient developed abdominal pain and hemodynamic instability.
• Abdominal computed tomography (CT) revealed a splenic laceration and hemoperitoneum.

Findings:

• An initial conservative management approach was adopted.
• A follow-up CT showed no active splenic bleeding, indicating abdominal stabilization.

Implications:

• Despite abdominal improvement, the patient experienced decompensated heart failure, leading to death.
• This case underscores the critical risks associated with invasive procedures in elderly patients with multiple cardiovascular comorbidities.