Keimyung Med J.  2015 Dec;34(2):192-196. 10.0000/kmj.2015.34.2.192.

Splenic Injury after Colonoscopy in Patient on Anti-Platelet Agents : A Case Study

• Kim SJ
• Seo HT
• Jo IE
• Kwon WH
• Park HM
• Lee YK

• KMID: 2224187
• DOI: http://doi.org/10.0000/kmj.2015.34.2.192

Abstract

Colonoscopy is frequently used for lower GI tract screening tests. Although rare, splenic injury may develop in the high-risk patients on anticoagulants or antiplatelet agents. A 78-year-old female visited our hospital complaining of chest pain. She had taken antihyperlipidemic and antiplatelet agent with hyperlipidemia and 20%-stenosis in the left anterior descending artery. She was taken polypectomy after colonoscopy 4 years ago. The next day, after a follow-up colonoscopy for polypectomy, she complained epigastric and left upper abdominal discomfort. Pain intensity was not high, but next day, epigastric pain was increased, so coronary angiography was performed 2 days later using anticoagulants. Coronary angiography showed 40~50%-stenosis in the left anterior descending artery. Another antiplatelet agent was added. After 72 hours on colonoscopy, her pain was localized upper left abdominal area. Abdominal CT showed intracapsular bleeding in the spleen with a small amount of hemoperitoneum in the pelvis. Since her vital signs were stable, she was treated with conservative management. Her pain improved and discharged. One month later, she was taken Abdominal CT. CT showed the size of intracapsular fluid collection in the spleen was increased, but the whole fluid collection was liquidized. 2 weeks later, follow-up sonography showed the size of fluid collection conspicuously was reduced. The case reported herein is a splenic Injury after Colonoscopy in patient on antiplatelet agents.

Keyword

Anti-platelet agent; Colonoscopy; Splenic injury

MeSH Terms

Aged
Anticoagulants
Arteries
Chest Pain
Colonoscopy*
Coronary Angiography
Female
Follow-Up Studies
Hemoperitoneum
Hemorrhage
Humans
Hyperlipidemias
Lower Gastrointestinal Tract
Mass Screening
Pelvis
Platelet Aggregation Inhibitors
Spleen
Tomography, X-Ray Computed
Vital Signs
Anticoagulants
Platelet Aggregation Inhibitors