Splenic injury after colonoscopy is rare, serious, and may become a lethal complication of the procedure. The most likely mechanism is tension on the splenocolic ligament or on pre-existing adhesions due to manipulations of the colon, or as a result of a direct injury to the spleen during passage through the splenic flexure. Intraperitoneal adhesions or any underlying splenic pathology may increase the risk. It is usually diagnosed late since not clinically suspected.