12/05/2026
Splenical breakage as a rare complication of colonoscopy:
Splenic rupture after colonoscopy is a very rare but potentially lethal complication (incidence < 1 in 100,000), characterized by abdominal pain on the left side after the procedure. It usually occurs within the first 24 hours, although it may be delayed, and is confirmed by abdominal CT scan. Key aspects of post-colonoscopy splenic rupture: Symptoms: Severe pain in the upper left quadrant (left hypochondrium), pain in the left shoulder, hemodynamic instability, and acute anemia. Mechanisms: It occurs from excessive traction of the splenocholic ligament, adhesions, or direct trauma during colonoscope insertion. Risk Factors: Older age, female age, previous abdominal surgery, and therapeutic procedures (polypectomy). Diagnosis: Abdominal CT scan is the test of choice for identifying perisplenic hematoma, hemoperitoneum (blood in the cavity), or laceration of the spleen. Treatment: It can range from conservative management to urgent splenectomy (removal of the spleen) in cases of instability. Suspicion is important.
The sign of KEHR is a sharp pain referring to the left shoulder, often worsened by inspiration, indicating irritation of the diaphragm from blood (hemoperitoneum) or other irritants. It is a classic indicator of splenic rupture (spleen), but it can also occur from cysts, abscesses, or after a laparoscopy. Key aspects of Kehr's Sign: Pathophysiology: Blood in the upper abdomen irritates the phrenic nerve (\ (C_3-C_5\)), and the brain interprets this pain in the shoulder (dermatoma \ (C_{4}\)). Maneuver: Pain can be exacerbated by compressing the upper left quadrant of the abdomen while the patient is in supine decubitus. Common causes: Spleen rupture (traumatic or spontaneous), ruptured ectopic pregnancy, or carbon dioxide irritation after laparoscopy. Associated signs: It is often associated with the sign of Balance (fixed shimmering in the left hypochondrium). It is considered an early warning sign in abdominal trauma that requires immediate medical attention.
