Edição 2018

An uncommon diagnosis done by colonoscopy

Rita Seara Costa, Juliana Costa, Aníbal Ferreira, Carla Rolanda, Raquel Gonçalves

A 74-year-old female, with alcoholism and a previous chronic subdural haematoma, presented at the emergency department with a lipothymia without visible gastrointestinal bleeding or abdominal pain. Her blood pressure was 100/50mmHg with pulse of 96bpm and her labs showed only haemoglobin of 10.3g/dL (2 months before was 15g/dL). Upper endoscopy was normal. Total colonoscopy was also performed and showed shifting patches of bluish discoloration throughout the colon. The abdominal angio-CT was performed and showed hemoperitoneum secondary to splenic rupture with subcapsular haematoma. In the absence of recent trauma, the clinical diagnosis of a spleen rupture can be challenging. 

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Hospital de Braga