Superselective Splenic Artery Embolization for the Management of Splenic Laceration Following Colonoscopy

Overview

Journal Acta Radiol Short Rep

Specialty Radiology

Date 2014 Oct 10

PMID 25298862

Citations 10

Authors

Ian M Brennan

Salomao Faintuch

Barry Sacks

Affiliations

Soon will be listed here.

Abstract

Splenic injury is a rare complication following colonoscopy with fewer than 100 reported cases worldwide to date. We describe a case of splenic laceration presenting 5 days following diagnostic colonoscopy. Although hemodynamically stable, active contrast extravasation on contrast-enhanced multidetector computed tomography predicted likely failure of conservative management. Splenic artery angiography confirmed active extravasation from the lower splenic pole and the patient was successfully treated with super selective coil embolization of a lower pole splenic artery branch. This is the eighth reported case of endovascular treatment of splenic injury following colonoscopy. To our knowledge, however, superselective splenic artery embolization has not been previously reported to treat this rare endoscopic complication.

Citing Articles

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Splenic injuries secondary to colonoscopy: Rare but serious complication.

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References

Shankar S, Rowe S . Splenic injury after colonoscopy: case report and review of literature. Ochsner J. 2011; 11(3):276-81. PMC: 3179198. View

Schurr M, Fabian T, Gavant M, Croce M, Kudsk K, Minard G . Management of blunt splenic trauma: computed tomographic contrast blush predicts failure of nonoperative management. J Trauma. 1995; 39(3):507-12; discussion 512-3. DOI: 10.1097/00005373-199509000-00018. View

Holubar S, Dwivedi A, Eisdorfer J, Eisendorfer J, Levine R, Strauss R . Splenic rupture: an unusual complication of colonoscopy. Am Surg. 2007; 73(4):393-6. View

Levin T, Zhao W, Conell C, Seeff L, Manninen D, Shapiro J . Complications of colonoscopy in an integrated health care delivery system. Ann Intern Med. 2006; 145(12):880-6. DOI: 10.7326/0003-4819-145-12-200612190-00004. View

Corcillo A, Aellen S, Zingg T, Bize P, Demartines N, Denys A . Endovascular treatment of active splenic bleeding after colonoscopy: a systematic review of the literature. Cardiovasc Intervent Radiol. 2012; 36(5):1270-9. DOI: 10.1007/s00270-012-0539-1. View

Seeff L, Richards T, Shapiro J, Nadel M, Manninen D, Given L . How many endoscopies are performed for colorectal cancer screening? Results from CDC's survey of endoscopic capacity. Gastroenterology. 2004; 127(6):1670-7. DOI: 10.1053/j.gastro.2004.09.051. View

Pfefferkorn U, Hamel C, Viehl C, Marti W, Oertli D . Haemorrhagic shock caused by splenic rupture following routine colonoscopy. Int J Colorectal Dis. 2005; 22(5):559-60. DOI: 10.1007/s00384-005-0750-5. View

van der Vlies C, van Delden O, Punt B, Ponsen K, Reekers J, Goslings J . Literature review of the role of ultrasound, computed tomography, and transcatheter arterial embolization for the treatment of traumatic splenic injuries. Cardiovasc Intervent Radiol. 2010; 33(6):1079-87. PMC: 2977075. DOI: 10.1007/s00270-010-9943-6. View

Stein D, Myaing M, Guillaume C . Splenic rupture after colonoscopy treated by splenic artery embolization. Gastrointest Endosc. 2002; 55(7):946-8. DOI: 10.1067/mge.2002.124639. View

10.

WHERRY D, ZEHNER Jr H . Colonoscopy-fiberoptic endoscopic approach to the colon and polypectomy. Med Ann Dist Columbia. 1974; 43(4):189-92. View

11.

Michetti C, Smeltzer E, Fakhry S . Splenic injury due to colonoscopy: analysis of the world literature, a new case report, and recommendations for management. Am Surg. 2010; 76(11):1198-204. DOI: 10.1177/000313481007601117. View

12.

Bessoud B, Denys A, Calmes J, Madoff D, Qanadli S, Schnyder P . Nonoperative management of traumatic splenic injuries: is there a role for proximal splenic artery embolization?. AJR Am J Roentgenol. 2006; 186(3):779-85. DOI: 10.2214/AJR.04.1800. View

13.

Haan J, Biffl W, Knudson M, Davis K, Oka T, Majercik S . Splenic embolization revisited: a multicenter review. J Trauma. 2004; 56(3):542-7. DOI: 10.1097/01.ta.0000114069.73054.45. View

14.

Ahmed A, Eller P, Schiffman F . Splenic rupture: an unusual complication of colonoscopy. Am J Gastroenterol. 1997; 92(7):1201-4. View

15.

Petersen C, Adamsen S, Gocht-Jensen P, Arnesen R, Hart-Hansen O . Splenic injury after colonoscopy. Endoscopy. 2007; 40(1):76-9. DOI: 10.1055/s-2007-966940. View

16.

de Vries J, Ronnen H, Oomen A, Linskens R . Splenic rupture following colonoscopy, a rare complication. Neth J Med. 2009; 67(6):230-3. View

17.

Parker W, Edwards M, Bittner 4th J, Mellinger J . Splenic hemorrhage: an unexpected complication after colonoscopy. Am Surg. 2008; 74(5):450-2. View

18.

Kamath A, Iqbal C, Sarr M, Cullinane D, Zietlow S, Farley D . Colonoscopic splenic injuries: incidence and management. J Gastrointest Surg. 2009; 13(12):2136-40. DOI: 10.1007/s11605-009-1064-7. View

19.

Marmery H, Shanmuganathan K, Alexander M, Mirvis S . Optimization of selection for nonoperative management of blunt splenic injury: comparison of MDCT grading systems. AJR Am J Roentgenol. 2007; 189(6):1421-7. DOI: 10.2214/AJR.07.2152. View

20.

Fishback S, Pickhardt P, Bhalla S, Menias C, Congdon R, Macari M . Delayed presentation of splenic rupture following colonoscopy: clinical and CT findings. Emerg Radiol. 2011; 18(6):539-44. DOI: 10.1007/s10140-011-0982-3. View