Volchok Japa, Cohn Michael
Department of Surgery University of Massachusetts Medical School at Berkshire Medical Center, Pittsfield, Massachusetts 01201, USA.
JSLS. 2006 Jan-Mar;10(1):114-6.
Appendicitis and splenic rupture are 2 rare complications of colonoscopy reported in the literature. To our knowledge splenic rupture following colonoscopy has been reported 17 times in the English-language literature and is associated with excess traction on the splenocolic ligament. Appendicitis after colonoscopy has been reported only 9 times and is usually associated with obstruction of the appendiceal lumen with fecal matter during colonoscopy.
We present the case reports of 2 patients: a 76-year-old woman who presented in consultation 24 hours after a routine colonoscopy with massive hemoperitoneum secondary to splenic rupture, seen on computed tomographic (CT) scan, who then underwent splenectomy; the second, a 60-year-old male who presented to the emergency room 16 hours after colonoscopy with clinical and computed tomographic scan findings of acute appendicitis who underwent a laparoscopic appendectomy.
Treatment of both patients resulted in resolution of their complications, splenic rupture and appendicitis. They both had an uneventful postoperative course and are doing well several months postoperatively.
We report 2 rare complications of colonoscopy, splenic rupture and appendicitis. In the setting of a recent colonoscopy and abdominal pain, a high index of suspicion is needed for their diagnosis.
阑尾炎和脾破裂是文献中报道的结肠镜检查的两种罕见并发症。据我们所知，英文文献中报道结肠镜检查后脾破裂17次，与脾结肠韧带过度牵拉有关。结肠镜检查后阑尾炎仅报道过9次，通常与结肠镜检查期间阑尾腔被粪便阻塞有关。
我们报告2例患者的病例：1例76岁女性，在常规结肠镜检查24小时后因脾破裂导致大量腹腔积血前来会诊，计算机断层扫描（CT）显示后接受了脾切除术；另1例60岁男性，在结肠镜检查16小时后因急性阑尾炎的临床和CT扫描结果前往急诊室，接受了腹腔镜阑尾切除术。
两名患者的并发症，即脾破裂和阑尾炎，经治疗后均得到缓解。他们术后恢复顺利，术后数月情况良好。
我们报告了结肠镜检查的2种罕见并发症，即脾破裂和阑尾炎。在近期有结肠镜检查且出现腹痛的情况下，诊断时需要高度怀疑。
