Haemorrhagic shock caused by splenic rupture following routine colonoscopy
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We report a case of acute abdominal pain with haemorrhagic shock, which was caused by a splenic rupture, following a routine colonoscopy. Splenic rupture is a rare but potentially fatal complication. It should be considered in patients with signs of haemorrhagic shock after colonoscopy, but with no evidence of gastrointestinal bleeding.
A 62-year-old woman presented in our emergency department with acute abdominal pain. On physical examination the patient showed hypotension (80/55 mmHg), a heart rate of 96/min and diffuse abdominal tenderness and guarding in all four quadrants.
Twelve hours earlier the patient underwent a routine follow-up colonoscopy 2 years after curative radiotherapy for anal squamous cell carcinoma. The colonoscopy was performed under intravenous sedation with propofol with no reported difficulties. Shortly after the procedure the patient reported pain radiating to the left shoulder and arm. Due to the fact that this pain subsided spontaneously, the...