Case Report
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World J Gastrointest Surg. Oct 27, 2013; 5(10): 259-263
Published online Oct 27, 2013. doi: 10.4240/wjgs.v5.i10.259
Post-colonoscopy appendicitis: A case report and systematic review
Darcy Shaw, Gabriel Gallardo, Marc D Basson
Darcy Shaw, Gabriel Gallardo, Marc D Basson, Department of Surgery, College of Human Medicine, Michigan State University, Lansing, MI 48906, United States
Author contributions: All the authors contributed to the manuscript writing and revision.
Correspondence to: Marc D Basson, MD, PhD, Department of Surgery, College of Human Medicine, Michigan State University, 1200 East Michigan Avenue, Lansing, MI 48906, United States. marc.basson@hc.msu.edu
Telephone: +1-517-2672487 Fax: +1-517-2672488
Received: July 7, 2013
Revised: September 23, 2013
Accepted: October 16, 2013
Published online: October 27, 2013
Abstract

Colonoscopy is a widely used diagnostic and therapeutic modality with a relatively low morbidity. However, given the large volume of procedures performed, awareness of the infrequent complications is essential. Perforation is an established complication of colonoscopy, and can range from 0.2%-3% depending on the series, population and modality of colonoscopy. Acute appendicitis after colonoscopy is an extremely rare event, and a cause-effect relationship between the colonoscopy and the appendicitis is not well documented. In addition, awareness of this condition can aid in prompt diagnosis. Relatively mild symptoms and exclusion of bowel perforation by contrast studies do not exclude appendicitis from the differential diagnosis for post-colonoscopy pain. In addition to the difficult diagnosis inherent to postcolonoscopy appendicitis, treatment strategies have varied greatly. This paper reviews these approaches. We also expand upon prior articles by giving guidance for the role of nonoperative management in these patients. This case and review of the literature will help to create awareness about this complication, and guide optimal treatment of pericolonoscopy appendicitis.

Keywords: Colonoscopy complications, Appendicitis

Core tip: The manuscript highlights a recent interesting case from our institution demonstrating appendicitis after colonoscopy, which was managed surgically. This paper reviews the relevant literature including all related previously published cases, and makes recommendations about defining the syndrome of post-colonoscopy appendicitis and how it should be managed.