McBride Rachael, Dasari Bobby, Magowan Hannah, Mullan Michael, Yousaf Mahammad, Mackle Eamon
Department of Surgery, Craigavon Area Hospital, Portadown, UK.
BMJ Case Rep. 2013 Jun 3;2013:bcr2013009126. doi: 10.1136/bcr-2013-009126.
We present a case of a middle-aged woman, who presented with abdominal pain less than 24 h following an uneventful colonoscopy for rectal bleeding. Initial diagnosis was thought to be colonic perforation. An urgent CT scan performed owing to dropping haemoglobin and blood pressure revealed a large perisplenic haematoma. An urgent laparotomy was performed in which the patient had a total blood loss of 2500 ml and required splenectomy. The patient recovered well postoperatively.Colonoscopy is a commonly performed procedure in which complications of perforation and bleeding are well recognised. This case represents one of the rare but serious complications that endoscopists and patients should be aware of to aid prevention and early diagnosis.
我们报告一例中年女性病例，该患者在因直肠出血接受顺利的结肠镜检查后不到24小时出现腹痛。初步诊断考虑为结肠穿孔。由于血红蛋白和血压下降而进行的紧急CT扫描显示脾周有巨大血肿。遂进行了紧急剖腹手术，术中患者失血总量达2500毫升，需要行脾切除术。患者术后恢复良好。结肠镜检查是一种常用的操作，其穿孔和出血并发症已广为人知。本病例代表了一种罕见但严重的并发症，内镜医师和患者都应予以关注，以助于预防和早期诊断。
