Wang Jason, Choi Heesun, Ashurst John
Touro University Nevada College of Osteopathic Medicine, Henderson, Nevada.
Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona.
Clin Pract Cases Emerg Med. 2021 Nov;5(4):499-501. doi: 10.5811/cpcem.2021.2.50676.
Colonoscopy is a commonly performed outpatient procedure with a low risk of complications. The most common complications seen in the postoperative period include hemorrhage and perforation. Infrequently, splenic injury can occur.
A 72-year-old male presented with a one-day history of left upper quadrant pain following colonoscopy. During the procedure he had two polyps removed along the transverse colon near the splenic flexure. There were no complications during the procedure or in the immediate post-operative period. On presentation to the emergency department, abdominal tenderness was present in the left upper quadrant without rebound, rigidity, or guarding. Point-of-care ultrasound of the abdomen demonstrated mixed hypoechoic densities confined to the splenic capsule, and computed tomography of the abdomen and pelvis with intravenous contrast noted a grade II/III splenic laceration without active extravasation. The patient was admitted for serial abdominal examination and labs.
Splenic injury following colonoscopy is a rare complication of colonoscopy. Emergency providers should be aware of this possible complication, and acute management should include basic trauma care and consultation for possible intervention, if warranted.
结肠镜检查是一种常见的门诊手术，并发症风险较低。术后最常见的并发症包括出血和穿孔。脾损伤虽不常见，但也可能发生。
一名72岁男性在结肠镜检查后出现左上腹疼痛一天。在手术过程中，他在脾曲附近的横结肠处切除了两个息肉。手术过程中和术后即刻均无并发症。到急诊科就诊时，左上腹有压痛，但无反跳痛、肌紧张或肌卫现象。床旁腹部超声显示脾包膜内有混合性低回声密度影，腹部和盆腔增强CT显示Ⅱ/Ⅲ级脾裂伤，无活动性外渗。患者入院接受系列腹部检查和实验室检查。
结肠镜检查后脾损伤是结肠镜检查的一种罕见并发症。急诊医护人员应意识到这种可能的并发症，急性处理应包括基本的创伤护理，并在必要时咨询是否需要进行可能的干预。
