[Splenic trauma: an unusual complication of colonoscopy with polypectomy] : Le traumatisme splénique : une complication rare de la coloscopie avec polypectomie

Nicolas Pichon (1) , Muriel Mathonnet (2, 3) , François Verdière (4) , Paul Carrier (5)

1 Service de Réanimation Polyvalente [CHU Limoges]
2 HCP - Homéostasie Cellulaire et Pathologies
3 Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges]
4 Service de Radiologie et Imagerie Médicale [CHU Limoges]
5 Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]

Nowadays, colonoscopy has become an invaluable tool in the diagnosis and treatment of diseases of the colon and rectum. Colonoscopy is still an invasive exam with several complications. The most common complications are perforation and bleeding, which occur in up to 1% after diagnostic colonoscopy and 3% of patients undergoing therapeutic colonoscopy. Less common complications include pneumothorax, pneumomediastinum, colonic volvulus, hernia incarceration, retroperitoneal abscess and mesenteric tear. Splenic rupture is a rare and potentially lethal colonoscopic complication with less than 45 cases reported in the world. The overall incidence is 0.004%. Mechanisms of injury and available treatment options remain discussed. We present a case of splenic rupture after colonoscopy with polypectomy in a 73-year-old woman managed first with nonoperative treatment and nine days later with surgical treatment. As the indications for colonoscopy expand, including the introduction of mass screening for colorectal cancer, endoscopists should be increasingly aware of that life-threatening complication after colonoscopy and know the emergency treatment.

Domaines: Hépatologie et Gastroentérologie

Nicolas Pichon, Muriel Mathonnet, François Verdière, Paul Carrier. [Splenic trauma: an unusual complication of colonoscopy with polypectomy] : Le traumatisme splénique : une complication rare de la coloscopie avec polypectomie. Gastroentérologie Clinique et Biologique / Research and Clinics in Hepatology and Gastroenterology, 2008, 32 (2), pp.123-7. ⟨10.1016/j.gcb.2007.10.005⟩. ⟨hal-00594348⟩