Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2023; 11(36): 8563-8567
Published online Dec 26, 2023. doi: 10.12998/wjcc.v11.i36.8563
Colonoscopy-induced acute appendicitis: A case report
Xiao-Ling Song, Jin-You Ma, Zhi-Gao Zhang
Xiao-Ling Song, Jin-You Ma, Zhi-Gao Zhang, Department of Gastroenterology, Sunshine Union Hospital, Weifang 261000, Shandong Province, China
Author contributions: Song XL designed the research plans and wrote the manuscript; Ma JY contributed to the index detection, collation and analysis of original results; Zhang ZG proposed the feasibility analysis of the research scheme and revised the paper.
Informed consent statement: Written informed consent was obtained.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Gao Zhang, MD, Deputy Director, Department of Gastroenterology, Sunshine Union Hospital, No. 999 Yingqian Street, Weifang 261000, Shandong Province, China. techmed@126.com
Received: October 16, 2023
Peer-review started: October 16, 2023
First decision: November 1, 2023
Revised: November 11, 2023
Accepted: December 12, 2023
Article in press: December 12, 2023
Published online: December 26, 2023
Processing time: 67 Days and 5.3 Hours
Abstract
BACKGROUND

Colonoscopy is widely used for examination, diagnosis, and treatment because of its low incidence of associated complications. Post-colonoscopy appendicitis (PCA) is very rare and is easily misdiagnosed as electrocoagulation syndrome or colon perforation. Therefore, clinicians should pay close attention to this complication.

CASE SUMMARY

A 47-year-old female patient underwent a colonoscopy for a systematic physical examination, and the procedure was uneventful with normal endoscopic and histologic findings. However, the bowel preparation was suboptimal (Boston 2-3-2). After the examination, the patient experienced pain in the lower abdomen, which progressively worsened. Computed tomography of the lower abdomen and pelvis revealed appendiceal calcular obstruction and appendicitis. As the patient refused surgery, she was managed with antibiotics and recovered well.

CONCLUSION

In the current literature, the definition of PCA remains unclear. However, abdominal pain after colonoscopy should be differentiated from acute appendicitis.

Keywords: Colonoscopy; Complications; Appendicitis; Differential diagnosis; Case report

Core Tip: Abdominal pain is a common symptom after colonoscopy and is generally considered to be caused by perforation or electrocoagulation syndrome. Acute appendicitis is often ignored as a differential diagnosis. This case report aims to improve clinicians’ awareness of possible appendicitis after colonoscopy. The causal relationship between colonoscopy and acute appendicitis remains unclear. However, regardless of whether it is defined as a complication, it should be differentiated from colonoscopy-associated abdominal pain, particularly in the right lower abdomen.