Splenic rupture after colonoscopy

Splenic trauma is a rare but potentially fatal complication of colonoscopy.

A 74-year-old woman presented at the emergency department with abdominal pain. She had undergone a colonoscopy three days prior that had revealed a tumour in the transverse colon. After arriving at the hospital, her haemoglobin level gradually decreased and she eventually developed symptoms of hypovolaemia. A CT scan of the abdomen and pelvis with intravenous contrast showed a splenic haematoma and hemoperitoneum. The patient underwent a splenectomy and hemicolectomy due to the tumour in the transverse colon.

Splenic injury is a rare but potentially fatal complication of colonoscopy, which it is important to be aware of given the increasing use of colonoscopy. Patients presenting with abdominal pain and hemodynamic instability following colonoscopy should raise strong suspicion of splenic injury.