We present a rare and previously undocumented potential complication of computed tomography (CT) colonography. CT colonography is a commonly performed investigation with a relatively low risk of complications. While splenic injury is a well-documented complication after colonoscopy, it has never been reported following CT colonography. A 64-year-old man presented with severe abdominal pain four hours after CT colonography. CT of his abdomen and pelvis revealed appearances consistent with intra-abdominal bleeding secondary to splenic injury. The patient immediately underwent an emergency laparotomy and splenectomy, revealing a grade III splenic capsular tear. Histological evaluation of splenic tissue showed normal morphology with no evidence of malignancy. While the aetiology of the patient's splenic injury remains uncertain, normal histopathology and the chronology of events represents an almost certain link to CT colonography.
Keywords: CT colonography; Colonoscopy; Pneumocolon; Spleen; Splenectomy.