Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different large bowel diseases.

Splenic injury is a rare complication of colonoscopy with few cases described; the first one was in 1974.

No specific causes have been established but probably the mechanism of injury may be related to direct trauma or excessive traction on the splenocolic ligament.

Clinical presentation occurs generally within the first 24 h after colonoscopy but in some cases a late presentation is described (more than 48 h) with subtle symptoms and arduous diagnosis.

Treatment should be addressed to clinics, splenic injury grading and hemodynamic status of patients