Authors: Ashwin S Kamath Corey W Iqbal Michael G Sarr Daniel C Cullinane Scott P Zietlow David R Farley Mark D Sawyer
Publish Date: 2009/10/15
Volume: 13, Issue: 12, Pages: 2136-
Abstract
Splenic injuries that occur during colonoscopies are rare There is no available incidence of this serious complication and the literature is limited to case reports Our study looks at single institution experience of splenic injuries during colonoscopy to define the incidence and management of this serious complicationFour patients of 296248 colonoscopies sustained a splenic injury directly from colonoscopy performed at our institution incidence 0001 Three additional patients were treated at our tertiary referral center after splenic injury from colonoscopy performed elsewhere The mean age at the time of colonoscopy was 54 years range 40–70 years The most common presenting symptom was abdominal pain n = 4 with a mean decrease in hemoglobin of 65 g/dl range 45–85 g/dl Splenic injury was diagnosed by computed tomography in five patients Six patients received a mean of 55 U of packed red blood cells range 2–14 U All patients were managed with splenectomy six patients within 24 h of the index colonoscopy and one patient presented more than 24 h after initial colonoscopy There was no evidence of preexisting splenic disease in any of the patients by surgical pathology and there were no postoperative complications or deaths The mean duration of stay was 10 days range 7–15 days All patients are alive at a median follow up of 22 months range 1–164 months
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