Iatrogenic Splenic Injury Following Colonoscopy: A Rare Complication

A 66-year-old woman developed severe epigastric pain and vomiting shortly after an outpatient colonoscopy. Initial clinical assessment and plain radiographs were inconclusive, but contrast-enhanced CT of the abdomen demonstrated a perisplenic hematoma with intraperitoneal blood consistent with splenic injury. She was hemodynamically stable on presentation and required blood transfusion for acute normocytic anemia. Given the absence of active arterial bleeding or peritonitis, the multidisciplinary team elected conservative management: hospital admission to a high-dependency unit for close monitoring, intravenous fluids, analgesia, broad-spectrum antibiotics, and serial hemoglobin and vital-sign assessments. No surgical or endovascular intervention was necessary; the patient's symptoms and laboratory indices improved, and she was discharged in stable condition with follow-up arranged. This case highlights splenic injury as a rare but potentially serious complication of colonoscopy that may present without classic signs of perforation. Early recognition, appropriate imaging, and individualized management, particularly conservative care in selected stable patients, can avoid unnecessary surgery and reduce morbidity.