Haemoperitoneum Following Colonoscopy due to Tear of the Splenocolic Ligament: Revisit of the Splenic Ligaments

Full Article

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.