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一例常规结肠镜检查后发生的医源性脾损伤,严重脊柱侧弯导致的独特解剖结构可能起到了影响作用。

A Case of Iatrogenic Splenic Injury Following Routine Colonoscopy With Possible Influence of Unique Anatomy Due to Severe Scoliosis.

作者信息

Wright Jacob B, Gray Sanjiv, Huynh Dustin

机构信息

Surgical Critical Care, University of Central Florida College of Medicine, Orlando, USA.

Surgery, University of Central Florida College of Medicine, Orlando, USA.

出版信息

Cureus. 2021 Apr 7;13(4):e14352. doi: 10.7759/cureus.14352.

Abstract

Iatrogenic splenic injury is a rare complication of all abdominal surgeries. Despite the procedure's overall safety, colonoscopy is now the procedure most frequently associated with iatrogenic splenic injury. A 58-year-old male with a past medical history of hypertension, lung cancer in remission, colon polyps, and severe scoliosis presented for grade three splenic laceration two days following a routine colonoscopy. He had no recent history of injury or other inciting events that could have led to traumatic injury. Non-operative management included splenic artery embolization and transfusion of one unit of packed red blood cells, after which he improved in the hospital and was discharged home in stable condition. This case postulates the possible influence of his severe scoliosis, and thus altered abdominal viscera anatomy, on his iatrogenic splenic injury, as well as the potential importance of investigating scoliosis as a risk factor for difficult colonoscopy or even iatrogenic splenic injury during colonoscopy.

摘要

医源性脾损伤是所有腹部手术中罕见的并发症。尽管手术总体安全,但结肠镜检查目前是与医源性脾损伤最常相关的手术。一名58岁男性,有高血压、肺癌缓解期、结肠息肉和严重脊柱侧弯病史,在常规结肠镜检查两天后出现三级脾撕裂伤。他近期没有可能导致创伤性损伤的受伤史或其他诱发事件。非手术治疗包括脾动脉栓塞和输注一个单位的浓缩红细胞,之后他在医院病情好转,出院时情况稳定。该病例推测了他严重的脊柱侧弯以及由此改变的腹部脏器解剖结构对其医源性脾损伤的可能影响,以及将脊柱侧弯作为结肠镜检查困难甚至医源性脾损伤风险因素进行调查的潜在重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c138/8105188/c8afecc5da55/cureus-0013-00000014352-i01.jpg

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