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However, splenic injury after colonoscopy is considered a rare complication and less than 100 cases have been reported in international literature. Interestingly, this is the first case report demonstrating systemic lupus erythematosus (SLE) as a possible risk factor leading to splenic rupture post-colonoscopy. Failure to recognise this possibility even in its rarity can lead to life-threatening complications. We present a case of an acute splenic rupture with massive intraperitoneal bleeding after colonoscopy in a patient with SLE.<\/jats:p>","DOI":"10.1136\/bcr-2019-229262","type":"journal-article","created":{"date-parts":[[2019,7,13]],"date-time":"2019-07-13T04:25:17Z","timestamp":1562991917000},"page":"e229262","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Splenic rupture as a rare and unpredicted complication in a patient with systemic lupus erythematosus after colonoscopy"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7085-1167","authenticated-orcid":false,"given":"Subhanudh","family":"Thavaraputta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Passisd","family":"Laoveeravat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhakhathorn","family":"Thavaraputta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariwan","family":"Rakvit","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,12]]},"reference":[{"key":"2025082711405515000_12.7.e229262.1","doi-asserted-by":"crossref","first-page":"2479","DOI":"10.1002\/cncr.30070","article-title":"Colorectal cancer screening: estimated future colonoscopy need and current volume and capacity","volume":"122","author":"Joseph","year":"2016","journal-title":"Cancer"},{"key":"2025082711405515000_12.7.e229262.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2005.06.037"},{"key":"2025082711405515000_12.7.e229262.3","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s13193-015-0410-3","article-title":"Colonoscopy in colorectal cancer screening: current aspects","volume":"6","author":"Triantafillidis","year":"2015","journal-title":"Indian J Surg Oncol"},{"key":"2025082711405515000_12.7.e229262.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.06.023"},{"key":"2025082711405515000_12.7.e229262.5","first-page":"321","article-title":"Complication rates in colonoscopy screening for cancer","volume":"114","author":"Zwink","year":"2017","journal-title":"Dtsch Arztebl Int"},{"key":"2025082711405515000_12.7.e229262.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9218-9"},{"key":"2025082711405515000_12.7.e229262.7","unstructured":"Waseem M , Bjerke S . 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