A Very Rare Cause of Splenic Injury: Splenic Hematoma Following a Diagnostic Upper Endoscopy (Esophagogastroduodenoscopy) and Biopsy of Gastric Ulcer

The potential for splenic injury from esophagogastroduodenoscopy (EGD) is exceptionally low. To our knowledge, less than five cases have been reported in literature. Though still uncommon, splenic rupture due to diagnostic or therapeutic procedures is more frequently described following colonoscopy and endoscopic retrograde cholangiopancreatography. We report a 62-year-old Caucasian male with primary squamous cell carcinoma of the lung who presented 2 days after an EGD and gastric ulcer biopsy. The patient complained of severe left upper quadrant abdominal pain with rebound tenderness. Upon further evaluation, a diagnosis of a large subcapsular splenic hematoma was made with computed tomography (CT) imaging. The mechanism of splenic injury attributable to EGD is traction on the greater curvature of the stomach, causing avulsion of the splenic or short gastric vessels. We feel this case represents a very rare yet serious complication of EGD that warrants consideration and further investigation.