Splenic laceration following routine colonoscopy: a case report

Splenic injury is a rare but potentially life-threatening complication of colonoscopy. We report the case of a 63-year-old woman who developed left upper quadrant and referred shoulder pain one day after a routine colonoscopy. Computed tomography of the abdomen revealed a peri-splenic hematoma, and she was transferred to a tertiary facility for further management. Repeat imaging confirmed a splenic laceration with associated hemoperitoneum. She underwent splenic artery embolization with microcoils, resulting in stabilization of her hemoglobin after transfusion. The patient was discharged on hospital Day 6 without further complications. This case underscores the importance of considering splenic injury in the differential diagnosis for post-colonoscopy abdominal or shoulder pain, particularly after other more common etiologies have been excluded. Early recognition and prompt intervention can be critical in preventing morbidity and mortality.