Though rare, a perisplenic hematoma is a potentially life-threatening complication of colonoscopies that is important to identify in patients presenting with abdominal pain following the procedure. In our case, a 62-year-old female patient presented to the emergency department (ED) with abdominal pain, tachycardia, and new anemia following a routine colonoscopy. Computed tomography (CT) showed a large perisplenic hematoma with small-to-moderate hemoperitoneum. Injury to the spleen during a colonoscopy may occur due to multiple mechanisms, including adhesions, traction of attached ligaments, and direct trauma. Management of splenic injury can include conservative management, splenic artery embolization, and splenectomy. In the case of our patient, given the absence of ongoing bleeding, she was admitted to the general surgery service and monitored with serial abdominal exams and hemoglobin checks. After her initial resuscitation with blood products, she remained hemodynamically stable and was discharged from the hospital in a stable condition.
Maryanov et al. (Wed,) studied this question.