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CASE REPORT
Emergency splenectomy postelective colonoscopy
  1. Carolyn Cullinane,
  2. Jaroslaw Gudyma,
  3. Gerarde McArdle
  1. General Surgery, Daisy Hill Hospital, Newry, County Down, UK
  1. Correspondence to Carolyn Cullinane, cc3189{at}hotmail.com

Summary

Colonoscopy is the gold standard for investigation of colorectal carcinoma and inflammatory bowel disease. Splenic injury is a rare but potentially fatal complication of colonoscopy. The present case study outlines the early clinical presentation and rapid deterioration of a patient with a splenic injury after an elective colonoscopy. A 70-year-old female underwent a colonoscopy for investigation of altered bowel habit. The procedure was documented as difficult due to the presence of ‘stiff loopy colon’. In recovery, patient’s condition deteriorated and she was moved to the ward for further assessment. She gradually became haemodynamically unstable and displayed signs of peritoneal irritation. Initial attempts of fluid resuscitation failed to improve patient’s clinical condition. Further testing revealed a significant drop in haemoglobin and CT confirmed the diagnosis of a splenic rupture. She underwent an emergency splenectomy that evening. Postoperatively she was managed in the high dependency unit.

  • Gastrointestinal surgery
  • Endoscopy
  • General surgery
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Footnotes

  • Contributors CC: responsible for collecting data (including patient and radiologist consent), literature review and writing of paper.

    JG: responsible for editing and supervising paper.

    GM: responsible for emergency splenectomy.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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