{"id":1861,"date":"2009-10-01T01:00:00","date_gmt":"2009-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/"},"modified":"2018-10-20T18:39:48","modified_gmt":"2018-10-20T16:39:48","slug":"une-coloscopie-et-des-rates-derate","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/","title":{"rendered":"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)!"},"content":{"rendered":"

2009<\/strong><\/p>\n

PIERRE-NICOLAS M.,PEYRE D., RANZ-KRIKKEN I., ANDRIANAIVO D., PAYEN JL.<\/em><\/p>\n

Gastroent\u00e9rologie <\/strong>– \u00a02009-05-26 –\u00a0PW –<\/p>\n

________________________________<\/p>\n

La rupture spl\u00e9nique apr\u00e8s coloscopie est une complication grave mais rare d\u00e9crite la premi\u00e8re fois en 1974.<\/p>\n

Nous rapportons le cas d’une femme ag\u00e9e de 89 ans qui au d\u00e9cours d’une coloscopie avec polypectomie a pr\u00e9sent\u00e9 une douleur de l’hypocondre gauche et un syndrome de bas d\u00e9bit avec convulsions. Le bilan biologique r\u00e9v\u00e9lait une an\u00e9mie aigue et une hyperleucocytose mod\u00e9r\u00e9e. Un scanner a montr\u00e9 un volumineux h\u00e9matome sous-capsulaire spl\u00e9nique avec rupture intra-p\u00e9riton\u00e9ale et h\u00e9mop\u00e9ritoine massif. Une spl\u00e9nectomie d’h\u00e9mostase par laparotomie a \u00e9t\u00e9 r\u00e9alis\u00e9e avec des suites op\u00e9ratoires simples.<\/p>\n

La rupture de rate est une complication exceptionnelle de la coloscopie.
\nDeux articles, en 1991 et 1994, colligeant 36000 coloscopies ne relate qu\u2019un cas de rupture spl\u00e9nique.
\nLe tableau clinique associe :
\n –\tune douleur de l\u2019hypochondre gauche irradiant \u00e0 l\u2019\u00e9paule homo lat\u00e9rale (90%)
\n –\tune an\u00e9mie aigu\u00eb (68%)
\n –\tune hyperleucocytose (87%) <\/p>\n

Le diagnostic est fait dans les 24 premi\u00e8res heures dans 67% des cas. Le m\u00e9canisme exact de la rupture de rate lors d\u2019une coloscopie reste inconnu, mais plusieurs hypoth\u00e8ses sont discut\u00e9es :
\n –\tle traumatisme direct
\n –\tla traction excessive sur les ligaments spl\u00e9no-coliques lors du passage de l\u2019angle gauche ou de man\u0153uvres de d\u00e9bouclage
\n –\tl\u2019accolement anormal de la rate et du colon, le plus souvent en relation avec adh\u00e9rences post op\u00e9ratoires qui limitent sa mobilit\u00e9
\nDes facteurs favorisant la rupture spl\u00e9nique sont avanc\u00e9s :
\n –\tune spl\u00e9nom\u00e9galie ou une pathologie spl\u00e9nique sous jacente, une pancr\u00e9atite ou une maladie inflammatoire du colon
\n –\tla r\u00e9alisation d\u2019un geste endoluminal (biopsie ou polypectomie) ou des man\u0153uvres externes de compression abdominale
\n –\tun traitement anticoagulant
\nIl semblerait au contraire que la position en d\u00e9cubitus lat\u00e9ral gauche diminue le risque de l\u00e9sion spl\u00e9nique.<\/p>\n

Le traitement peut \u00eatre soit radical (spl\u00e9nectomie), soit conservateur.
\nSur 27 cas collig\u00e9s en 2007, 19 ont b\u00e9n\u00e9fici\u00e9 d\u2019une spl\u00e9nectomie.
\nElle semble \u00eatre indiqu\u00e9e en cas :
\n – d\u2019\u00e2ge avanc\u00e9
\n – de patient h\u00e9modynamiquement instable
\n – de pathologie spl\u00e9nique ant\u00e9rieure sous-jacente
\n – d\u2019atteinte du hile spl\u00e9nique
\nLe traitement conservateur peut \u00eatre envisag\u00e9 en cas de rupture sous capsulaire sans atteinte du hile spl\u00e9nique.<\/p>\n","protected":false},"excerpt":{"rendered":"

2009 PIERRE-NICOLAS M.,PEYRE D., RANZ-KRIKKEN I., ANDRIANAIVO D., PAYEN JL. Gastroent\u00e9rologie – \u00a02009-05-26 –\u00a0PW – ________________________________ La rupture spl\u00e9nique apr\u00e8s coloscopie est une complication grave mais rare d\u00e9crite la premi\u00e8re fois en 1974. Nous rapportons le cas d’une femme ag\u00e9e de 89 ans qui au d\u00e9cours d’une coloscopie avec polypectomie a pr\u00e9sent\u00e9 une douleur de […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[20],"class_list":["post-1861","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-20"],"yoast_head":"\nUne coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)! - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)! - Abstracts des congr\u00e8s de l'ANGH\" \/>\n<meta property=\"og:description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta property=\"og:url\" content=\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\" \/>\n<meta property=\"og:site_name\" content=\"Abstracts des congr\u00e8s de l'ANGH\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ANGH-2136322560030484\/\" \/>\n<meta property=\"article:published_time\" content=\"2009-10-01T00:00:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2018-10-20T16:39:48+00:00\" \/>\n<meta name=\"author\" content=\"abstracts\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"abstracts\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\"},\"author\":{\"name\":\"abstracts\",\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1\"},\"headline\":\"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)!\",\"datePublished\":\"2009-10-01T00:00:00+00:00\",\"dateModified\":\"2018-10-20T16:39:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\"},\"wordCount\":425,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#organization\"},\"keywords\":[\"2009\"],\"articleSection\":[\"Gastroenterologie\"],\"inLanguage\":\"fr-FR\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\",\"url\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\",\"name\":\"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)! - Abstracts des congr\u00e8s de l'ANGH\",\"isPartOf\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#website\"},\"datePublished\":\"2009-10-01T00:00:00+00:00\",\"dateModified\":\"2018-10-20T16:39:48+00:00\",\"description\":\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\",\"breadcrumb\":{\"@id\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\/\/angh.net\/abstracts\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)!\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/angh.net\/abstracts\/#website\",\"url\":\"https:\/\/angh.net\/abstracts\/\",\"name\":\"Abstracts des congr\u00e8s de l'ANGH\",\"description\":\"Base de donn\u00e9es des abstracts du congr\u00e8s depuis 2003\",\"publisher\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/angh.net\/abstracts\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/angh.net\/abstracts\/#organization\",\"name\":\"ANGH\",\"url\":\"https:\/\/angh.net\/abstracts\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg\",\"contentUrl\":\"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg\",\"width\":48,\"height\":18,\"caption\":\"ANGH\"},\"image\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/ANGH-2136322560030484\/\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1\",\"name\":\"abstracts\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g\",\"caption\":\"abstracts\"},\"url\":\"https:\/\/angh.net\/abstracts\/author\/abstracts\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)! - Abstracts des congr\u00e8s de l'ANGH","description":"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/","og_locale":"fr_FR","og_type":"article","og_title":"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)! - Abstracts des congr\u00e8s de l'ANGH","og_description":"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study","og_url":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/","og_site_name":"Abstracts des congr\u00e8s de l'ANGH","article_publisher":"https:\/\/www.facebook.com\/ANGH-2136322560030484\/","article_published_time":"2009-10-01T00:00:00+00:00","article_modified_time":"2018-10-20T16:39:48+00:00","author":"abstracts","twitter_card":"summary_large_image","twitter_misc":{"\u00c9crit par":"abstracts","Dur\u00e9e de lecture estim\u00e9e":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/#article","isPartOf":{"@id":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/"},"author":{"name":"abstracts","@id":"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1"},"headline":"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)!","datePublished":"2009-10-01T00:00:00+00:00","dateModified":"2018-10-20T16:39:48+00:00","mainEntityOfPage":{"@id":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/"},"wordCount":425,"commentCount":0,"publisher":{"@id":"https:\/\/angh.net\/abstracts\/#organization"},"keywords":["2009"],"articleSection":["Gastroenterologie"],"inLanguage":"fr-FR"},{"@type":"WebPage","@id":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/","url":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/","name":"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)! - Abstracts des congr\u00e8s de l'ANGH","isPartOf":{"@id":"https:\/\/angh.net\/abstracts\/#website"},"datePublished":"2009-10-01T00:00:00+00:00","dateModified":"2018-10-20T16:39:48+00:00","description":"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study","breadcrumb":{"@id":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/angh.net\/abstracts\/une-coloscopie-et-des-rates-derate\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/angh.net\/abstracts\/"},{"@type":"ListItem","position":2,"name":"Une coloscopie et des rat\u00e9s (d\u00e9rat\u00e9)!"}]},{"@type":"WebSite","@id":"https:\/\/angh.net\/abstracts\/#website","url":"https:\/\/angh.net\/abstracts\/","name":"Abstracts des congr\u00e8s de l'ANGH","description":"Base de donn\u00e9es des abstracts du congr\u00e8s depuis 2003","publisher":{"@id":"https:\/\/angh.net\/abstracts\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/angh.net\/abstracts\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/angh.net\/abstracts\/#organization","name":"ANGH","url":"https:\/\/angh.net\/abstracts\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/","url":"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg","contentUrl":"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg","width":48,"height":18,"caption":"ANGH"},"image":{"@id":"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ANGH-2136322560030484\/"]},{"@type":"Person","@id":"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1","name":"abstracts","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g","caption":"abstracts"},"url":"https:\/\/angh.net\/abstracts\/author\/abstracts\/"}]}},"_links":{"self":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/posts\/1861","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/comments?post=1861"}],"version-history":[{"count":0,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/posts\/1861\/revisions"}],"wp:attachment":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/media?parent=1861"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/categories?post=1861"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/tags?post=1861"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}