Haemoperitoneum Following Colonoscopy due to Tear of the Splenocolic Ligament: Revisit of the Splenic Ligaments
VKP Fung, WK Chau, JSF Shum, WK Kan
Hong Kong J Radiol 2014;17:189-93
DOI: 10.12809/hkjr1413187
Splenic injury or splenic ligament tear following colonoscopy is a rare but potentially life-threatening complication. It is often overlooked due to its bizarre clinical presentation and non-specific imaging features. It commonly presents as a delayed but serious complication that results in massive haemoperitoneum due to splenic injury. Urgent radiological or surgical intervention is required to control the bleeding and stabilise the patient’s condition. The imaging features in relation to the relevant radiological anatomy have seldom been discussed in radiology literature. We report a case of massive haemoperitoneum following colonoscopy. The preliminary findings in preoperative computed tomography scan and digital subtraction angiography were confirmed during surgery which showed a tear in the splenocolic ligament with active bleeding. In addition, we review the anatomy of splenic ligaments and nearby vessels, and the role of computed tomography scan and digital subtraction angiography in identifying these structures. Knowledge about the relevant anatomy is crucial in understanding the pathogenesis and treatment options for this condition.
中文摘要
結腸鏡檢查後因脾結腸韌帶撕裂出現腹腔積血：再次探查脾韌帶
馮啟邦、周偉強、岑承輝、簡偉權
結腸鏡檢查後脾損傷或脾韌帶撕裂是一種罕見但可能危及生命的併發症。由於這情況奇異的臨床表現和非特異性影像學特徵，此症往往會被忽視。此症通常表現為一種遲發性嚴重併發症，患者因脾損傷而引致大量腹腔積血，須以緊急介入或外科手術控制出血及穩定病情。放射學文獻中很少討論涉及放射學解剖的影像學特徵。本文報告一宗結腸鏡檢查後出現大量腹腔積血的病例。術前CT掃描和術中數字減影血管造影的初步結果顯示脾結腸韌帶撕裂並有活動性出血。本文並會回顧脾韌帶和附近血管的解剖結構，以及CT掃描和數字減影血管造影識別這些結構中的作用。相關解剖結構知識對理解該症的發病機制和治療方案選擇至關重要。