Erin G Andrade1, Olubode A Olufajo2, Eleanor L Drew2, Grant V Bochicchio2, Laurie J Punch2. 1. Washington University School of Medicine, Department of Surgery, Section of Acute and Critical Care Surgery, Campus Box 8109, 660 S. Euclid Ave, St. Louis, MO, 63110, United States. Electronic address: dawsonerin@wustl.edu. 2. Washington University School of Medicine, Department of Surgery, Section of Acute and Critical Care Surgery, Campus Box 8109, 660 S. Euclid Ave, St. Louis, MO, 63110, United States.
Abstract
BACKGROUND: Post colonoscopy blunt splenic injury (PCBSI) is a rarely reported and poorly recognized event. We analyzed cases of PCBSI managed at our hospital and compared them to existing literature. METHODS: We identified 5 patients admitted with PCBSI through chart review. RESULTS: There were 5 cases of PCBSI identified from April 2016-July 2017. Four of the patients were older than 65 years, three had prior surgeries, and all were women. CT scans showed splenic laceration in 4 cases, hemoperitoneum in 4 cases, and left pleural effusion in 2 cases. Three patients were treated with coil embolization, 1 had open splenectomy, and 1 was observed. CONCLUSIONS: Although blunt splenic injury is an infrequently reported complication of colonoscopy, it can result in high-grade injury requiring transfusion and invasive treatment due to significant hemorrhage. As previously reported, we demonstrate a high rate of PCBSI in women over 55 with a history of prior abdominal surgery. These data suggest that a high index of suspicion for splenic injury post-colonoscopy should be present in this population.
BACKGROUND: Post colonoscopy blunt splenic injury (PCBSI) is a rarely reported and poorly recognized event. We analyzed cases of PCBSI managed at our hospital and compared them to existing literature. METHODS: We identified 5 patients admitted with PCBSI through chart review. RESULTS: There were 5 cases of PCBSI identified from April 2016-July 2017. Four of the patients were older than 65 years, three had prior surgeries, and all were women. CT scans showed splenic laceration in 4 cases, hemoperitoneum in 4 cases, and left pleural effusion in 2 cases. Three patients were treated with coil embolization, 1 had open splenectomy, and 1 was observed. CONCLUSIONS: Although blunt splenic injury is an infrequently reported complication of colonoscopy, it can result in high-grade injury requiring transfusion and invasive treatment due to significant hemorrhage. As previously reported, we demonstrate a high rate of PCBSI in women over 55 with a history of prior abdominal surgery. These data suggest that a high index of suspicion for splenic injury post-colonoscopy should be present in this population.