World Journal of Emergency Surgery

unofficial impact factor 1.01

Open Access Case report

Splenic rupture after colonoscopy: Report of a case and review of literature

Alessandro Cappellani1, Maria Di Vita1*, Antonio Zanghì1, Andrea Cavallaro2, Giovanni Alfano1, Gaetano Piccolo1 and Emanuele Lo Menzo3

Author Affiliations

1 University of Catania Medical School, Policlinico, Department of Surgery, Catania, Italy

2 University of Catania Medical School, Policlinico, Fellowship in Surgical Physio-Pathology, Catania, Italy

3 University of Miami, Miller School of Medicine, Department of Surgery, Miami, Florida, USA

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World Journal of Emergency Surgery 2008, 3:8 doi:10.1186/1749-7922-3-8

Published: 9 February 2008

Abstract

Splenic rupture is a rare complication of colonoscopy. For this reason the diagnosis could be delayed and the outcome dismal. Fifty-four cases of splenic rupture after colonoscopy have been described in the literature. The majority of the cases required emergent or delayed splenectomy, 13 of these cases were treated conservatively. The main feature that stands out from the review of the literature is the "surprise" of this unexpected complication. This factor explains the elevated mortality (2 out of 54 cases), likely due to the delay in diagnosis. The case here described is probably among the most complex published in the literature; in fact the presence of dense intra-abdominal adhesions not only contributed to the complication itself, but also explain the confinement of the hemoperitoneum to the left supra-mesocolic space and the delayed presentation (13 days from the time of the trauma).