Colonoscopic splenic injury appears greatly underreported and may have an incidence rate that qualifies it as a significant public health issue given current clinical volumes of colonoscopy. The spectrum of clinical injury is likely much broader than reflected in reported cases. Better and earlier recognition of mild injury might prevent serious bleeding later through prescription of reduced physical activity. To date, investigation of splenic injury has been case reports. Systematic investigation of splenic injury is needed to determine accurate incidence rates and to identify technical rules for colonoscopy technique that will minimize this complication. Colonoscopic splenic injury warrants more attention.
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