Thompson Katrina, Stier Michael A
Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI, 53792.
J Forensic Sci. 2018 Mar;63(2):619-621. doi: 10.1111/1556-4029.13574. Epub 2017 Jun 9.
A 64-year-old woman was found dead at home after undergoing a screening colonoscopy. At autopsy, 1.9 L of blood was discovered within her abdominal cavity. The only major abnormality was nontraumatic avulsion of the splenic capsule. This was the only identifiable abnormality capable of causing the severe hemoperitoneum and demise of the patient. Although rare, splenic capsule avulsion is a recognized complication of colonoscopy. Many have theorized that it results from excessive traction on the splenocolic ligament resulting in a tear of the splenic capsule. Most patients present within the first 24 hours after the procedure with nonspecific symptoms, and many patients may not seek medical attention. The paucity of the literature in the area of splenic capsular avulsion after colonoscopy reinforces the importance of reporting known cases, and by doing so raise awareness of this rare but devastating complication of an otherwise beneficial screening procedure.
一名64岁女性在接受结肠镜筛查后被发现死于家中。尸检时，在其腹腔内发现了1.9升血液。唯一的主要异常是脾包膜非创伤性撕脱。这是唯一能够导致严重腹腔积血和患者死亡的可识别异常。尽管罕见，但脾包膜撕脱是结肠镜检查公认的并发症。许多人推测，它是由于脾结肠韧带受到过度牵拉导致脾包膜撕裂所致。大多数患者在术后24小时内出现非特异性症状，许多患者可能不会就医。结肠镜检查后脾包膜撕脱领域的文献匮乏，这凸显了报告已知病例的重要性，通过这样做提高对这种罕见但具有毁灭性的并发症的认识，而结肠镜检查原本是一种有益的筛查程序。
