Abstract
We report on a case of splenic injury in an 85-year old man following a diagnostic colonoscopy. The patient was sedated with intravenous midazolam and pethidine hydrochloride. The colonoscopic examination was completed uneventfully and the endoscopic findings were normal. Approximately 30 minutes after the procedure, the patient complained of left upper abdominal pain and went into a state of shock. An abdominal CT revealed hemo peritoneum. As the patient stabilized hemodynamically and the pain reduced in severity, we selected non-operative management. On the third day after admission, he complained of severe abdominal pain of acute onset and went into a state of shock again. Abdominal CT revealed extravasation, therefore, we performed transcatheter arterial embolization, however, the bleeding was venous therefore, we immediately performed open splenectmy. The patient made an uneventful recovery and was discharged home on the 19th day after admission to the hospital. Splenic injury following colonoscopy is rare, however, a delay in the diagnosis could be fatal. Endoscopists should therefore pay close attention when patients complain of abdominal pain after a colonoscopy.
