Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2021; 9(1): 245-251
Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.245
Endoscopic treatment for acute appendicitis with coexistent acute pancreatitis: Two case reports
Zhi-Qiang Du, Wen-Juan Ding, Fei Wang, Xiang-Rong Zhou, Tian-Ming Chen
Zhi-Qiang Du, Wen-Juan Ding, Fei Wang, Xiang-Rong Zhou, Tian-Ming Chen, Department of Gastroenterology, Jianyang People’s Hospital of Sichuan Province, Jianyang 641400, Sichuan Province, China
Author contributions: Du ZQ and Chen TM conceived the study; Ding WJ and Wang F assembled and analyzed the data; Ding WJ and Zhou XR contributed to the discussion of the article; Du ZQ reviewed and edited the article; All authors read and approved the submitted manuscript.
Informed consent statement: Written informed consent was obtained from all patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Juan Ding, MSc, Chief Doctor, Department of Gastroenterology, Jianyang People’s Hospital of Sichuan Province, No. 180 Yiyuan Road, Jianyang 641400, Sichuan Province, China. 1139045213@qq.com
Received: August 24, 2020
Peer-review started: August 24, 2020
First decision: September 23, 2020
Revised: October 7, 2020
Accepted: November 2, 2020
Article in press: November 2, 2020
Published online: January 6, 2021
Processing time: 130 Days and 9.5 Hours
Abstract
BACKGROUND

Appendectomy is the procedure of choice for the treatment of acute appendicitis. However, surgery may not be appropriate for patients with coexisting severe illness or comorbidities such as acute pancreatitis (AP). Endoscopic retrograde appendicitis treatment (ERAT) may be a novel alternative to surgery for treating such patients where existing medical therapies have failed.

CASE SUMMARY

We report 2 cases of moderately severe AP who developed acute uncomplicated appendicitis during their hospital stay and did not respond to traditional medical therapy. One patient had moderately severe AP due to hyperlipidemia, while the other patient had a gallstone induced by moderately severe AP. Neither patient was fit to undergo an appendectomy procedure because of the concurrent AP. Therefore, the alternative and minimally invasive ERAT was considered. After written informed consent was collected from the patients, the ERAT procedure was performed. Both patients exhibited fast postoperative recovery after ERAT with minimal surgical trauma.

CONCLUSION

ERAT is a safe and effective minimally invasive endoscopic procedure for acute appendicitis in patients with coexistent AP.

Keywords: Endoscopic retrograde appendicitis treatment; Acute pancreatitis; Acute appendicitis; Minimally invasive endoscopic procedure; Safety and effectiveness; Case report

Core Tip: Endoscopic retrograde appendicitis treatment (ERAT) is a minimally invasive technique for the treatment of acute appendicitis. We performed ERAT in 2 patients with moderately severe acute appendicitis with uncomplicated acute pancreatitis after the failure of traditional medical therapy. Both patients exhibited fast recovery without the need to perform an appendectomy procedure and retained the potential physi-ological function of the appendix. There were no postprocedure complications. We believe that ERAT can be a suitable alternative to appendectomy in high-risk patients of acute appendicitis with coexisting severe illnesses.