Iatrogenic Splenic Injury After Colonoscopy – Cureus
- colonoscopies are a vital tool for colorectal cancer screening and diagnosis, generally considered safe.
- The spleen, located in the upper left abdomen, plays a crucial role in filtering blood, storing white blood cells, and fighting infection.Injury to the spleen can range from...
- Important Note: Splenic injury following a colonoscopy is exceedingly rare.
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Understanding Rare Risks During Colonoscopies: Splenic Injury
Table of Contents
colonoscopies are a vital tool for colorectal cancer screening and diagnosis, generally considered safe. Though, like all medical procedures, they carry a small risk of complications. A recently documented, though rare, complication is iatrogenic splenic injury – damage to the spleen caused by the procedure itself. This article, updated November 12, 2025, explores this risk, its causes, and what patients should know.
What is the Spleen and Why is Injury a Concern?
The spleen, located in the upper left abdomen, plays a crucial role in filtering blood, storing white blood cells, and fighting infection.Injury to the spleen can range from minor bruising to a life-threatening rupture, leading to internal bleeding.While the spleen can often repair itself, notable damage may require surgical intervention, including potential splenectomy – surgical removal of the spleen. Individuals without a spleen are at increased risk of infection, necessitating vaccinations and, sometimes, prophylactic antibiotics.
How Can a Colonoscopy Cause Splenic Injury?
Splenic injury during a colonoscopy is typically iatrogenic,meaning it’s caused by medical intervention. The most common mechanism involves excessive traction or pressure on the splenic flexure – the bend in the colon near the spleen – during the procedure. This can occur when navigating the colonoscope, notably if there are anatomical variations or adhesions present. According to case reports, the injury isn’t always promptly apparent and can manifest hours or even days after the colonoscopy.
Reported Cases and Patient Demographics
Analysis of reported cases reveals that splenic injury following colonoscopy, while uncommon, has been documented across a range of patient demographics. A review of cases indicates that women appear to be disproportionately affected, possibly due to anatomical differences. The time between the procedure and symptom onset varies,but delayed recognition of the injury is a recurring theme. Symptoms can include left upper quadrant pain, often radiating to the left shoulder (Kehr’s sign), and signs of internal bleeding, such as dizziness or weakness.
| Characteristic | Observation |
|---|---|
| Gender Predisposition | Higher incidence in women |
| Symptom Onset | Variable, frequently enough delayed (hours to days) |
| Common Symptoms | Left upper quadrant pain, Kehr’s sign, signs of internal bleeding |
Diagnosis and Treatment
Diagnosing splenic injury typically involves imaging studies, such as a computed tomography (CT) scan of the abdomen. A CT scan can reveal the extent of the injury and identify any internal bleeding. Treatment depends on the severity of the injury. Minor injuries may be managed conservatively wiht observation and pain control. More significant injuries may require endoscopic intervention, such as clipping or cauterization, or, in severe cases, surgical repair or splenectomy.
Prompt recognition and appropriate management are crucial in minimizing morbidity associated with iatrogenic splenic injury.
What Should patients Do?
If you experience persistent or worsening left upper quadrant pain, especially radiating to the left shoulder, or