Rare Complications Following Colonoscopy: Case Reports of Splenic Rupture and Appendicitis

BACKGROUND: Appendicitis and splenic rupture are 2 rare complications of colonoscopy reported in the literature. To our knowledge splenic rupture following colonoscopy has been reported 17 times in the English-language literature and is associated with excess traction on the splenocolic ligament. Appendicitis after colonoscopy has been reported only 9 times and is usually associated with obstruction of the appendiceal lumen with fecal matter during colonoscopy. METHODS: We present the case reports of 2 patients: a 76-year-old woman who presented in consultation 24 hours after a routine colonoscopy with massive hemoperitoneum secondary to splenic rupture, seen on computed tomographic (CT) scan, who then underwent splenectomy; the second, a 60-year-old male who presented to the emergency room 16 hours after colonoscopy with clinical and computed tomographic scan findings of acute appendicitis who underwent a laparoscopic appendectomy. RESULTS: Treatment of both patients resulted in resolution of their complications, splenic rupture and appendicitis. They both had an uneventful postoperative course and are doing well several months postoperatively. CONCLUSIONS: We report 2 rare complications of colonoscopy, splenic rupture and appendicitis. In the setting of a recent colonoscopy and abdominal pain, a high index of suspicion is needed for their diagnosis.