Conclusions
Splenic rupture is an unusual but serious complication of LC. It has to be diagnosed and treated if possible during the laparoscopic procedure. The identification of a lesion of the anterior edge or the inferior pole of the spleen is possible during laparoscopy if the spleen is observed at the end of the procedure, whereas the detection of a posterior subcapsular haematoma of the spleen is impossible during laparoscopy and cannot be suspected if there is no bleeding from the spleen at the end of the procedure. Such a haematoma is not detectable after laparoscopy if the patient remains asymptomatic, and symptoms only occur after the haematoma ruptures.
However, we suggest visualization of the spleen at the end of LC to ensure early recognition and management of such cases. Obviously, manipulating the spleen is not necessary but we do believe it would be reasonable to wait for some seconds and see if there is any bleeding.
Imaging may be useful to diagnose such a haematoma but ultrasound and CT are unlikely to be performed in asymptomatic patients.