Hépato-Gastro & Oncologie Digestive


Splenic injury during a colonoscopy: a not so rare complication! Volume 28, issue 6, Juin 2021


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1 Haute Autorité de Santé – Direction Amélioration Qualité et Sécurité des Soins
2 Clinique des Cèdres, 31700 Cornebarrieu
3 Hospices civils de Lyon, Hôpital E. Herriot, Service d’hépato-gastroentérologie, 69437 Lyon Cedex 03
4 Hôpital Saint-Joseph, Marseille
5 Collège Formation Evaluation Accréditation en Hépatogastroentérologie (CEFA-HGE)
6 Centre Hospitalier Inter-Communal (CHIC), Créteil
* Correspondance

Splenic subcapsular hematomas, tears or ruptures of the spleen are rare complications of colonoscopy (around 0.5 per 10,000 procedures), but potentially serious (5% mortality). The occurrence is probably underestimated and under-reported. Every gastroenterologist should be aware that this complication is likely to occur once, or even several times, during his career as an endoscopist. This complication can be delayed, up to 4 days, after discharge. Every endoscopist should be aware about this risk, think of it in case of abnormal abdominal pain post colonoscopy, as should emergency physicians receiving a patient after discharge from the endosocpy unit. The management of this complication, which is not necessarily surgical, is based on the precise assessment of the lesion by computed tomography and on the hemodynamic situation of the patient.