Author Discussion Series- Douglas K. Rex

Dr. Douglas Rex

Douglas K. Rex, MD, from the Indiana University Hospital in Indianapolis, Indiana, discusses his Thinking Outside the Box article titled “Colonoscopic splenic injury warrants more attention.” This article appears in the June 2013 issue of GIE.



This study discusses several aspects of splenic injury during colonoscopy.  First, it suggests that the injury is more frequent than is commonly recognized though it can have significant consequences for patients (splenectomy) and physicians (malpractice actions if splenectomy is involved).

Unfortunately, little is known about how the injury occurs.  The piece proposes mechanisms by which splenic injury may occur and suggests that additional investigation is warranted to develop rules for prevention of splenic injury.

Figure 1. CT image of the abdomen in an 85-year-old woman obtained 1 hour after a colonoscopy in which free blood in the peritoneal cavity was seen through the colon wall during withdrawal. She was symptomatic for only the first 30 minutes after the examination. The arrow indicates blood between the spleen and diaphragm.


Find this article in the June issue online here or on pages 941-943 of the print issue.

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