Eter Ahmad, Belliveau Rachel
Department of Internal Medicine, Princeton Community Hospital, 122 12th St, Princeton, WV 24740, USA.
West Virginia School of Osteopathic Medicine, 400 N Lee St, Lewisburg, WV 24901, USA.
J Clin Med Res. 2020 Apr;12(4):269-271. doi: 10.14740/jocmr4134. Epub 2020 Mar 30.
The potential for splenic injury from esophagogastroduodenoscopy (EGD) is exceptionally low. To our knowledge, less than five cases have been reported in literature. Though still uncommon, splenic rupture due to diagnostic or therapeutic procedures is more frequently described following colonoscopy and endoscopic retrograde cholangiopancreatography. We report a 62-year-old Caucasian male with primary squamous cell carcinoma of the lung who presented 2 days after an EGD and gastric ulcer biopsy. The patient complained of severe left upper quadrant abdominal pain with rebound tenderness. Upon further evaluation, a diagnosis of a large subcapsular splenic hematoma was made with computed tomography (CT) imaging. The mechanism of splenic injury attributable to EGD is traction on the greater curvature of the stomach, causing avulsion of the splenic or short gastric vessels. We feel this case represents a very rare yet serious complication of EGD that warrants consideration and further investigation.
食管胃十二指肠镜检查（EGD）导致脾损伤的可能性极低。据我们所知，文献报道的此类病例不足五例。尽管仍不常见，但诊断性或治疗性操作导致的脾破裂在结肠镜检查和内镜逆行胰胆管造影术后更为常见。我们报告一例62岁的白人男性，患有原发性肺鳞状细胞癌，在接受EGD和胃溃疡活检2天后就诊。患者主诉左上腹剧痛伴反跳痛。经进一步评估，计算机断层扫描（CT）成像诊断为巨大的脾包膜下血肿。EGD导致脾损伤的机制是胃大弯处受到牵拉，导致脾血管或胃短血管撕裂。我们认为该病例代表了EGD一种非常罕见但严重的并发症，值得关注和进一步研究。
