Subscribe to RSS
Download PDF
DOI: 10.1055/a-2304-8243
Direct vision endoscopic retrograde appendicitis therapy in the treatment of appendicitis with appendicolith in young women
Authors
Supported by: Supported by National Key Clinical Discipline and the program of Guangdong Provincial Clinical Research Center for Digestive Diseases (2020B1111170004)
A 31-year old woman who was preparing for pregnancy sought medical attention due to recurrent right lower abdominal pain. She was diagnosed with acute appendicitis with appendicolith after an ultrasound examination. Unwilling to undergo appendectomy, she opted for endoscopic intervention and underwent direct vision endoscopic retrograde appendicitis therapy.
The EyeMax subscope (Micro-Tech, Nanjing, China) was intubated into the appendiceal cavity, allowing direct observation of the mucosa ([Video 1], [Fig. 1]). A metronidazole saline solution was used for irrigation of the appendiceal cavity. Subscope examination revealed congestion and swelling of the mucosa in the appendiceal orifice and cavity, confirming the diagnosis of acute appendicitis ([Fig. 2]). An appendicolith, approximately 1 cm in size, was embedded in the middle of the appendiceal cavity and successfully removed using a basket ([Fig. 3], [Fig. 4]). Subsequent reintubation of the subscope confirmed the absence of residual appendicolith ([Fig. 5]). A 4-month follow-up showed no recurrence.
The EyeMax subscope is a direct vision system similar to Spyglass. The study emphasizes the utilization of the EyeMax subscope for direct visualization during observation, directed irrigation, and appendicolith removal. The absence of X-ray radiation makes it a suitable option for special populations, including children and pregnant women. Performing procedures under direct vision reduces the risk of incomplete flushing and stone removal, thereby lowering recurrence and misdiagnosis rates. Additionally, if needed, biopsy of appendiceal lesions can be conducted under direct vision.
Endoscopy_UCTN_Code_TTT_1AQ_2AI
E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy.
All papers include a high-quality video and are published with a Creative Commons
CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission
process. We grant 100% waivers to articles whose corresponding authors are based in
Group A countries and 50% waivers to those who are based in Group B countries as classified
by Research4Life (see: https://www.research4life.org/access/eligibility/).
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.
Conflict of Interest
The authors declare that they have no conflict of interest.
Correspondence
Publication History
Article published online:
07 May 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany