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Splenic Injury After Colonoscopy: Conservative Management Using CT

Joan C. Prowda1, Susan Garrett Trevisan2 and Anna S. Lev-Toaff3

1 Department of Radiology, Columbia University Medical Center, 177 Fort Washington Ave., MHB 3-244, New York, NY 10032.
2 Department of Radiology, Doylestown Hospital, Doylestown, PA 18901.
3 Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.



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  		Fig. 1A —85-year-old woman with splenic hematoma and hemoperitoneum presenting 5 days after colonoscopy, treated conservatively with clinical and CT follow-up. Initial CT through inferior part of spleen shows hypodense hematoma in posteromedial aspect.

 


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  		Fig. 1B —85-year-old woman with splenic hematoma and hemoperitoneum presenting 5 days after colonoscopy, treated conservatively with clinical and CT follow-up. Initial CT several centimeters caudal to A shows 4.5-cm fluid collection inferior in relation to spleen.

 


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  		Fig. 1C —85-year-old woman with splenic hematoma and hemoperitoneum presenting 5 days after colonoscopy, treated conservatively with clinical and CT follow-up. Initial CT through lower pelvis shows moderate amount of high density fluid in cul-de-sac.

 


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  		Fig. 1D —85-year-old woman with splenic hematoma and hemoperitoneum presenting 5 days after colonoscopy, treated conservatively with clinical and CT follow-up. Follow-up CT weeks later shows interval decrease in size of splenic hematoma.

 


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  		Fig. 1E —85-year-old woman with splenic hematoma and hemoperitoneum presenting 5 days after colonoscopy, treated conservatively with clinical and CT follow-up. Follow-up CT shows resolution of fluid collection inferior in relation to spleen.

 


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  		Fig. 2 —48-year-old woman presenting 7 days after colonoscopy with large subcapsular/perisplenic hematoma and small hemoperitoneum was treated conservatively with clinical and CT follow-up. Initial CT through spleen shows subcapsular hematoma of heterogeneous attenuation with mass effect on spleen.

 

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