Colonoscopy in the diagnosis and management of appendiceal disease

Abstract

In this editorial, we comment on the article published in the recent issue of the World Journal of Gastrointestinal Endoscopy. We focused on the understanding of appendiceal disease, and the various options for diagnosis and treatment via endoscopy. Some factors affecting the diagnosis and management of appendiceal diseases are also discussed. The existence of any organ has its natural rationality, and the appendix is such a magical organ. A growing number of experts and scholars have gradually come to a consensus that the appendix is not a useless evolutionary relic. There are many lymphocytes and lymph nodes in the appendix wall, which has a strong immune function, and this function is particularly important for children and adolescents. Many intestinal probiotics in the appendix are very helpful for maintaining the balance of the intestinal flora. With the continuous progress of endoscopic technology, endoscopic treatment involving preservation of the appendix has shown great advantages over surgery. In the diagnosis of appendiceal inflammation and neoplasms, colonoscopy, endoscopic retrograde appendicography and choledochoscopy help assess conditions of the appendix. Endoscopic retrograde appendicitis therapy, abscess drainage under colonoscopy, fenestration of abscess under colonoscopy, and endoscopic or natural orifice transluminal endoscopic surgery resection of appendiceal neoplasms are safe and effective endoscopic treatments for appendiceal disease. New breakthroughs in the application of endoscopy in the appendix are expected to occur in the near future.

Keywords: Appendicitis; Appendiceal neoplasms; Colonoscopy; Endoscopic ultrasonography

Core Tip: With the popularization of the concept of minimally invasive surgery and in-depth research on the function of the appendix, methods for preserving the appendix have emerged, and endoscopic diagnosis and treatment of appendiceal diseases have gradually become the first-line treatments. We summarize the current state of colonoscopic management of appendiceal disease, with an emphasis on reconsideration of the function of the appendix and endoscopic treatment. We also put forward our own views on how to improve the diagnosis and treatment of appendiceal diseases.