IMAGES IN MEDICINE
An uncommon complication of a common procedure
Franklin Square Hospital Center, Baltimore, Maryland, USA
Correspondence to:
Dr R Ranganath, Franklin Square Hospital Center, Franklin Square Drive, Baltimore, MD 21237, USA; rkrish_2001@yahoo.com
Keywords: endoscopy; gastroenterology; computed tomography; colonoscopy; splenic rupture
| The first 150 words of the full text of this article appear below. |
A 66-year-old woman was admitted with sudden onset of left upper quadrant pain associated with left shoulder pain, 3 h after a routine colonoscopy. A CT scan of the abdomen performed at presentation revealed a large subcapsular splenic haematoma (fig 1, arrows). There was no evidence of colonic perforation. She was admitted to the intensive care unit and managed conservatively with intravenous fluids and analgesics. She was discharged after a period of observation.
Figure 1 Abdominal CT scan showing a large subcapsular splenic haematoma (arrows).
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Splenic haematoma is a rare complication of colonoscopy. About 44 cases have been reported in the English literature. It occurs more commonly in women. The postulated mechanism is partial capsular avulsion secondary to traction on the splenocolic ligament.1 The incidence is higher in technically difficult procedures and in patients who have adhesions from prior surgery.
A high index of suspicion is the key to diagnosis,
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