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June 20, 1977

Splenic Rupture Following Colonoscopy

JAMA. 1977;237(25):2718. doi:10.1001/jama.1977.03270520028003

To the Editor.—  With the advent of the fiberoptic colonoscope, colonoscopy has been used more widely as a diagnostic and therapeutic procedure. Colonoscopic polypectomy has almost replaced the transabdominal polypectomy and has substantially reduced the mortality and the morbidity.Reported complications are primarily those of perforation and hemorrhage at the site of polypectomy. Rare complications include tear of the mesentery and injury to other intraabdominal viscera during manipulation of the colonoscope.We recently encountered the following case of unrecognized rupture of the spleen following colonoscopy.

Report of a Case.—  A 53-year-old woman who had a prior history of numerous colonic polyps was brought to the emergency room with a history of left upper quadrant pain radiating to the left shoulder. The pain started following an outpatient colonoscopic examination performed three days previously. The colonoscope was advanced to 50 cm. There was some difficulty in advancing the colonoscope through the sigmoid