Published online Feb 27, 2020. doi: 10.4240/wjgs.v12.i2.55
Peer-review started: September 6, 2019
First decision: September 28, 2019
Revised: November 23, 2019
Accepted: December 14, 2019
Article in press: December 14, 2019
Published online: February 27, 2020
Core tip: Colonoscopy is a safe diagnostic and therapeutic procedure for evaluation of large bowel diseases. Rarely, a splenic Injury can occur. We perform a structured search on four databases and selected 45 articles with 68 patients. The reason for colonoscopy, presentation of patient with spleen injury, types of injury, diagnosis, management and outcomes of patients were identified and analyzed. The most common reason for colonoscopy was screening (46%) followed by diagnostic colonoscopy (28%). Eighty seven percent of patients presented with abdominal pain. Patients with spleen rupture mostly required splenectomy (47%), while minor spleen hematomas and lacerations were managed conservatively (38%). Six percent of the patients were managed with proximal splenic artery splenic embolization and 4% were managed with laparoscopic repair. The overall mortality was 10% while 77% had complete recovery. Spleen rupture due to colonoscopy is a significant concern and is associated with high mortality. The management of the patients can be individualized based on clinical presentation.