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Milzruptur nach einer Routine-Koloskopie

Splenic rupture following routine colonoscopy

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Zusammenfassung

Hintergrund

Die Koloskopie ist eine weit verbreitete, komplikationsarme Methode zum Screening des kolorektalen Karzinoms. Eine seltene, jedoch vital bedrohliche Komplikation stellt eine Milzruptur nach Koloskopie dar.

Fallbericht

Bei der hier vorgestellten Patientin mit Milzruptur nach Koloskopie erfolgte nach verspäteter Diagnosestellung eine Splenektomie. Der weitere Verlauf gestaltete sich komplikationsreich.

Diskussion

Im Folgenden werden die zu dieser Komplikation beitragenden Risikofaktoren, das diagnostische und therapeutische Vorgehen sowie die Konsequenzen die aus dieser, möglicherweise nicht ganz so seltenen, Komplikation gezogen werden sollten, diskutiert. Die Kernaussage der Autoren ist, dass die Indikation zur Computertomographie bei abdominellen Beschwerden nach Koloskopie großzügig gestellt werden sollte, v. a. wenn kein Anhalt für eine eventuelle Darmperforation besteht.

Abstract

Background

Colonoscopy is a widely used method of screening for colorectal cancer. The rate of complications is low. Splenic rupture is a rare but potentially life-threatening complication of colonoscopy.

Case report

In the case described below, the diagnosis of splenic rupture was late which is why further treatment of the patient was associated with complications after emergency splenectomy had been performed.

Discussion

In this article we want to discuss the risk factors leading to splenic rupture after colonoscopy as well as consequences resulting therefrom concerning the diagnostic and therapeutic pathway for a complication that is likely to occur more frequently than currently presumed.

The main message is that one should perform computed tomography more urgently in patients having undergone colonoscopy and showing abdominal pain when there are no indications for bowel perforation.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. C. Pietsch gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Notfallzentrum, Krankenhaus der Barmherzigen Brüder, Regensburg, Deutschland

    G. Parsché, T. Brünnler & F. Rockmann

  2. Zentrale Notaufnahme, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739, Aschaffenburg, Deutschland

    C. Pietsch

Authors
  1. G. Parsché
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  2. T. Brünnler
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  3. F. Rockmann
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  4. C. Pietsch
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Correspondence to C. Pietsch.

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Parsché, G., Brünnler, T., Rockmann, F. et al. Milzruptur nach einer Routine-Koloskopie. Notfall Rettungsmed 16, 539–542 (2013). https://doi.org/10.1007/s10049-013-1760-4

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  • DOI: https://doi.org/10.1007/s10049-013-1760-4

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