Copyright
©The Author(s) 2020.
World J Gastrointest Surg. Feb 27, 2020; 12(2): 55-67
Published online Feb 27, 2020. doi: 10.4240/wjgs.v12.i2.55
Published online Feb 27, 2020. doi: 10.4240/wjgs.v12.i2.55
Table 1 Details of case reports and Clavein-Dindo Classification of Post-Operative complication (computed tomography)
Ref. | Age | Sex | Reason for colonoscopy | Type of injury | Diagnosis | Management | Clavein-Dindo classification of Post-Operative complication |
Keeven et al[7] | 52 | Male | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Suliman et al[8] | 59 | Female | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Diéguez Castillo et al[9] | 53 | Female | Bleeding | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Zhang et al[11] | 63 | Female | Weight Loss | Splenic injury/hematoma | CT | Conservative management | Grade I |
Chime et al[12] | 51 | Female | Screening | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Ungprasert et al[13] | 59 | Male | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Laiz Díez et al[14] | 40 | Female | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Laiz Díez et al[14] | 80 | Female | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Barbeiro et al[15] | 73 | Female | Bleeding | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Li et al[16] | 65 | Female | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Nallayici et al[17] | 71 | Male | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Pavlidis et al[19] | 74 | Male | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Steele et al[20] | 60 | Female | Screening | Splenic rupture | CT | Conservative management | Grade I |
Ozogul et al[21] | 69 | Female | Polypectomy | Splenic injury/hematoma | CT | Conservative management | Grade I |
Mccarty et al[24] | 71 | Male | Bleeding | Splenic injury/hematoma | CT | Conservative management | Grade I |
Jehangir et al[22] | 76 | Female | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Zappa et al[26] | 73 | Male | Abdominal pain | Splenic injury/hematoma | CT | Laparotomy/ splenectomy | Grade III |
Lahat et al[4] | 61 | Male | Screening | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Lahat et al[4] | 68 | Male | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Lahat et al[4] | 85 | Female | Polypectomy | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Lahat et al[4] | 54 | Male | Polypectomy | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Lahat et al[4] | 65 | Male | Screening | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Lahat et al[4] | 59 | Male | Polypectomy | Splenic injury/hematoma | CT | Laparoscopy | Grade III |
Mulkerin et al[27] | NA | NA | Screening | Splenic injury/hematoma | CT | Laparoscopy | Grade III |
García García et al[28] | 58 | Female | Screening | Splenic injury/hematoma | CT | Laparoscopy | Grade III |
Sbai et al[29] | 70 | Male | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Ng et al[31] | 63 | Female | Screening | Splenic injury/hematoma | CT-Angiogram | Conservative management | Grade I |
Mazulis et al[32] | 88 | Female | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Kapur et al[33] | 76 | Female | Bleeding | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Han et al[34] | 77 | Male | Polypectomy | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Brennan et al[38] | 75 | Female | Screening | Splenic injury/hematoma | CT | Proximal splenic artery embolization | Grade III |
Herreros de Tejada et al[39] | 65 | Female | Submucosal Dissection of tumor | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Lauretta et al[40] | 61 | Male | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Jamorabo et al[42] | 63 | Male | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Guner et al[44] | 53 | Male | Abdominal Pain | Splenic injury/hematoma | CT | Bed rest, blood transfusion, observation | Grade II |
McBride et al[45] | 64 | Female | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Rex et al[46] | 68 | Female | NA | NA | CT | Conservative management | Grade I |
Rex et al[46] | 52 | Female | Polypectomy | Splenic injury/hematoma | CT | Conservative management | Grade I |
Rex et al[46] | 61 | Female | NA | NA | CT | Conservative management | Grade I |
Rex et al[46] | 58 | Female | NA | NA | CT | Conservative management | Grade I |
Rex et al[46] | 74 | Female | NA | NA | CT | Conservative management | Grade I |
Rex et al[46] | 85 | Female | NA | NA | CT | Conservative management | Grade I |
Chow et al[47] | 84 | Female | Bleeding | Splenic injury/hematoma | CT | Fluids/blood/splenic artery embolization | Grade III |
Pineda et al[48] | 62 | Female | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Corcillo et al[49] | 66 | Male | Bleeding | Splenic rupture | CT | Proximal splenic artery embolization | Grade III |
Corcillo et al[49] | 77 | Female | Polypectomy | Splenic rupture | CT | Proximal splenic artery embolization | Grade III |
Abunnaja et al[50] | 62 | Female | Screening | Splenic injury/hematoma | CT | Ringers lactate, blood, splenectomy, vaccinations | Grade II |
González-Soler et al[51] | 67 | Male | Screening | Splenic rupture | CT | Laparotomy/splenectomy | Grade III |
Seifman et al[52] | 41 | Female | Screening | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Singla et al[54] | NA | NA | Screening | NA | CT | NA | NA |
Shankar et al[56] | 47 | Female | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Fishback et al[58] | 64 | Female | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Fishback et al[58] | 59 | Female | Bleeding | Splenic injury/hematoma | CT | Conservative management | Grade I |
Fishback et al[58] | 55 | Female | Bleeding | Splenic injury/hematoma | CT | Laparotomy/ splenectomy | Grade III |
Fishback et al[58] | 65 | Male | Polypectomy | NA | CT | Laparotomy/splenectomy | Grade III |
Fishback et al[58] | 56 | Female | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Fishback et al[58] | 51 | Female | Screening | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Fishback et al[58] | 54 | Female | Screening | Splenic injury/hematoma | CT | Conservative management | Grade I |
Fishback et al[58] | 68 | Female | Screening | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Fishback et al[58] | 84 | Female | Bleeding | Splenic injury/hematoma | CT | Conservative management | Grade I |
Fishback et al[58] | 64 | Male | Bleeding | Splenic injury/hematoma | CT | Conservative management | Grade I |
Fishback et al[58] | 64 | Male | Screening | Splenic injury/hematoma | CT | Proximal splenic artery embolization/splenectomy | Grade III |
Bertoglio et al[59] | 70 | Male | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Sachdev et al[61] | 68 | Female | Bleeding | Splenic injury/hematoma | CT | Laparotomy/splenectomy | Grade III |
Meier et al[62] | 68 | Female | Bleeding | NA | CT | Laparotomy/splenectomy | Grade III |
Table 2 Reason for colonoscopy and types of injury
Frequency | Valid percent | Colonoscopy reason | Frequency | Valid percent | |
Gender | |||||
Male | 23 | 35.9 | Screening | 31 | 45.6 |
Female | 41 | 64.1 | Bleeding | 19 | 27.9 |
Injury | Polypectomy | 9 | 13.2 | ||
Rupture | 15 | 22 | Abdominal pain | 2 | 2.9 |
Injury | 43 | 63.2 | Weight loss | 1 | 1.5 |
Table 3 Presentation, diagnosis and management of splenic injury
Presentation | Diagnosis and outcome | Management | ||||||
Female | Percent (%) | Female | Percent (%) | Female | Percent (%) | |||
Abdominal pain | 59 | 87 | CT | 67 | 98.5 | Laparotomy | 32 | 47.1 |
Syncope | 4 | 6 | CTPA | 1 | 1.5 | PSAE | 4 | 5.9 |
Dizziness | 3 | 5 | Survived | 52 | 76.5 | Conservative | 26 | 38.2 |
Chest pain | 1 | 1.5 | Died | 7 | 10.3 | Laparoscopy | 3 | 4.4 |
Table 4 Likelihood ratios for different comparisons
Comparison | Value | df | P value |
Abdominal pain and colonoscopy | 2.20 | 4 | 0.69 |
Spleen Injury and colonoscopy | 2.37 | 4 | 0.66 |
Splenectomy and colonoscopy | 6.4 | 12 | 0.89 |
Splenorrhaphy and colonoscopy | 6.8 | 12 | 0.91 |
Outcome and screening colonoscopy | 3.17 | 4 | 0.52 |
Outcome and diagnostic colonoscopy | 3.21 | 4 | 0.61 |
Table 5 Likelihood ratios and Fisher’s test for different comparisons
Comparison | Value | df | P value |
Splenectomy and spleen rupture (Likelihood ratio) | 8.1 | 3 | 0.04 |
Mortality and spleen rupture (Fisher’s test) | 4.8 | 1 | 0.028 |
- Citation: Ullah W, Rashid MU, Mehmood A, Zafar Y, Hussain I, Sarvepalli D, Hasan MK. Splenic injuries secondary to colonoscopy: Rare but serious complication. World J Gastrointest Surg 2020; 12(2): 55-67
- URL: https://www.wjgnet.com/1948-9366/full/v12/i2/55.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v12.i2.55