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Background <p>The incidence of splenic injuries due to colonoscopy is largely unknown but seems to be substantial in hospitalized patients. The risk may be lower in out-patients.</p> Objective <p>The incidence, risk factors, and outcome of splenic lesions was studied in 1.44 million cases with a complete out-patient colonoscopy.</p> Methods <p>Using an administrative data base of a health insurance company with 11 million insured subjects, patients undergoing out-patient colonoscopy associated with a splenic injury within 7&#xa0;days were retrieved from the records based upon OPS and EBM (comparable to ICPM) and ICD-10 codes. In each case identified (n = 163), the clinical course was reconstructed by 2 physicians. Patients with other causes of splenic injuries (abdominal surgery, trauma etc.) were excluded.</p> Results <p>Among 1,443,341 total colonoscopies in out-patients over a 5-year period, 46 splenic lesions were most likely solely due to colonoscopy. This accounts for 3.19 splenic injuries per 100,000 colonoscopies or 1 lesion in 31,400 patients. Afflicted patients were more likely to be female (relative risk: 1.7) than male. Surgical interventions were carried out in 19 cases (41%), predominantly splenectomy (n = 17), whereas 27 events (59%) were managed conservatively. Transfusions and intensive care treatment were predictors for the need of surgery. Most lesions (63%) were diagnosed within 48&#xa0;h after colonoscopy.</p> Conclusion <p>Administrative data analysis suggests that splenic Injuries due to colonoscopy are less frequent compared to hospitalized patients. Endoscopists should be aware of this rare and life-threatening adverse event.</p>

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Splenic Injuries Due to Colonoscopy in Adult Out-Patients—A Registry-Based Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月19日

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  • Herbert Koop,
  • Christoph Skupnik,
  • Torsten Schnoor,
  • Dirk Horenkamp-Sonntag

摘要

Background

The incidence of splenic injuries due to colonoscopy is largely unknown but seems to be substantial in hospitalized patients. The risk may be lower in out-patients.

Objective

The incidence, risk factors, and outcome of splenic lesions was studied in 1.44 million cases with a complete out-patient colonoscopy.

Methods

Using an administrative data base of a health insurance company with 11 million insured subjects, patients undergoing out-patient colonoscopy associated with a splenic injury within 7 days were retrieved from the records based upon OPS and EBM (comparable to ICPM) and ICD-10 codes. In each case identified (n = 163), the clinical course was reconstructed by 2 physicians. Patients with other causes of splenic injuries (abdominal surgery, trauma etc.) were excluded.

Results

Among 1,443,341 total colonoscopies in out-patients over a 5-year period, 46 splenic lesions were most likely solely due to colonoscopy. This accounts for 3.19 splenic injuries per 100,000 colonoscopies or 1 lesion in 31,400 patients. Afflicted patients were more likely to be female (relative risk: 1.7) than male. Surgical interventions were carried out in 19 cases (41%), predominantly splenectomy (n = 17), whereas 27 events (59%) were managed conservatively. Transfusions and intensive care treatment were predictors for the need of surgery. Most lesions (63%) were diagnosed within 48 h after colonoscopy.

Conclusion

Administrative data analysis suggests that splenic Injuries due to colonoscopy are less frequent compared to hospitalized patients. Endoscopists should be aware of this rare and life-threatening adverse event.