Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2024; 12(4): 801-805
Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.801
Endoscopic retrograde appendicitis treatment for periappendiceal abscess: A case report
Qiao-Mei Li, Bin Ye, Jun-Wei Liu, Shang-Wen Yang
Qiao-Mei Li, Bin Ye, Jun-Wei Liu, Shang-Wen Yang, Department of Gastroenterology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Co-first authors: Qiao-Mei Li and Jun-Wei Liu.
Author contributions: Li QM contributed to manuscript drafting; Liu JW was responsible for the revision of the manuscript for important intellectual content; Yang SW was the patient’s physicians; Ye B reviewed the literature; and all authors issued final approval for the version to be submitted.
Supported by the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, No. 2020KY1082 and No. 2021KY1238.
Informed consent statement: We sincerely appreciate the patient and his families for their cooperation in information acquisition, treatment, and follow-up.
Conflict-of-interest statement: All the authors report 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: Bin Ye, MD, Chief Physician, Department of Gastroenterology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. 376923236@qq.com
Received: October 7, 2023
Peer-review started: October 7, 2023
First decision: November 21, 2023
Revised: December 2, 2023
Accepted: January 15, 2024
Article in press: January 15, 2024
Published online: February 6, 2024
Processing time: 110 Days and 1.6 Hours
Abstract
BACKGROUND

Acute appendicitis is the most common abdominal emergency. At present, the main treatments for periappendiceal abscess include antibiotics and surgery. However, the complications and mortality of emergency surgery are high. The preferred therapy is conservative treatment with antibiotics first, ultrasound-guided puncture drainage or surgical treatment is followed when necessary. Endoscopic retrograde appendicitis therapy (ERAT) for acute uncomplicated appendicitis have been proved clinically effective, but it is rarely used in periappendiceal abscess.

CASE SUMMARY

We report a patient admitted to hospital because of “right lower abdominal pain for six days”. The computerized tomography (CT) of patient showed that appendicitis with fecaliths and abscess in the pelvis. The patient was treated by CT-guided puncture and drainage of abdominal abscess combined with ERAT to remove appendiceal fecaliths, irrigation and stent placement.

CONCLUSION

The patient did not receive surgery because of impoverished family. Abdominal pain did not recur during the follow-up period. This case confirms the value of ERAT in the treatment of periappendiceal abscess.

Keywords: Transparent cap; Colonoscopy; Endoscopic retrograde appendicitis therapy; Periappendiceal abscess; Case report

Core Tip: We report a patient admitted to hospital because of “right lower abdominal pain for six days”. The computerized tomography of patient showed that appendicitis with fecaliths and abscess in the pelvis. This case is appendiceal abscess treated by puncture drainage combined with endoscopic retrograde appendicitis therapy (ERAT) to prevent the recurrence of acute appendicitis, suggesting the feasibility of combining these two methods to treat patients with appendiceal abscess, and providing option for elderly patients who refuse surgery or cannot receive surgery because of poor health. Recently, research has confirmed that ERAT group has shorter hospitalization time, faster pain relief and lower acute appendicitis recurrence rate compared with antibiotic treatment alone, and ERAT can take out appendiceal fecaliths, which is a common cause of appendicitis. Therefore, we believe that ERAT can benefit for these patients.