Splenic injuries secondary to colonoscopy:Rare but serious complication

作     者：Waqas Ullah Mamoon Ur Rashid Asif Mehmood Yousaf Zafar Ishtiaq Hussain Deepika Sarvepalli Muhammad Khalid Hasan 

作者机构：Department of Internal MedicineAbington HospitalAbingtonPA 19001United States Department of Internal MedicineAdvent Health HospitalOrlandoFL 32804United States Department of Internal MedicineGeisinger Medical CenterDanvillePA 17822United States Department of Internal MedicineUMKC5100 Rockhill RdKansas CityMO 64110United States Department of GastroenterologyCleveland ClinicWestonFL 33331United States Department of GastroenterologyAdvent Health HospitalOrlandoFL 32804United States 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2020年第12卷第2期

页      面：55-67页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Colonoscopy Spleen Splenic rupture Systematic review Splenic injuries 

摘      要：BACKGROUND Colonoscopy is a safe and routine diagnostic and therapeutic procedure for evaluation of large bowel *** common procedure related complications include bleeding and perforation but rarely a splenic *** To investigate the reason for colonoscopy,presentation of patient with spleen injury,types of injury,diagnosis,management and outcomes of patients METHODS A structured search on four databases was done and 45 articles with 68 patients were *** reason for colonoscopy,presentation of patient with spleen injury,types of injury,diagnosis,management and outcomes of patients were identified and analyzed using *** The mean age of the patients was 62.7 years with 64%*** two percent had a complete splenic rupture with colonoscopy while 63%had subcapsular hematoma,spleen laceration and spleen *** most common reason for colonoscopy was screening(46%)followed by diagnostic colonoscopy(28%).Eighty seven percent of patients presented with abdominal *** 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 *** overall mortality was 10%while 77%had complete *** reason of colonoscopy against presentation specifically,abdominal pain showed no statistical significance P=*** indication of colonoscopy had no significant impact on incidence of splenic injury(P=0.89).Majority of the patients(47%)were managed with splenectomy while the rest were managed conservatively(P=0.04).This association was moderately strong at a cramer’s V test(0.34).The Fisher exact test showed a higher mortality with spleen rupture(P=0.028).CONCLUSION Spleen rupture due to colonoscopy is a significant concern and is associated with high *** management of the patients can be individualized based on clinical pre