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Chen Y, Guo SG, Fu XA, Fan ZQ, Yuan JQ, Zhang XX, Liu H, Liu Z, Huang YS, Song L. Modified single-port laparoscopic appendectomy using needle-type grasping forceps vs conventional three-port laparoscopic appendectomy for acute uncomplicated appendicitis. World J Gastrointest Surg 2025; 17:102607. [DOI: 10.4240/wjgs.v17.i4.102607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 01/17/2025] [Accepted: 02/08/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND Single-port laparoscopic appendectomy is an advanced minimally invasive surgery that involves the use of upgraded instruments and equipment. We previously modified single-port laparoscopic appendectomy with needle-type grasping forceps (mSLAN) for patients with simple appendicitis, but the feasibility and safety of our modified procedure need further evaluation in a high-quality clinical study.
AIM To compare the short-term clinical outcomes of mSLAN with those of conventional three-port laparoscopic appendectomy (CLA) for patients with acute uncomplicated appendicitis.
METHODS This single-center, single-blind, prospective, randomized controlled trial included patients who underwent emergency laparoscopic appendectomy for acute uncomplicated appendicitis at our center between April 2024 and August 2024. Patients were randomly divided into the mSLAN group or the CLA group via computer-generated randomization. The primary endpoint was the 24-hour postoperative visual analog scale (VAS) score, and the secondary endpoints included the operative time, 24-hour postoperative inflammatory response biomarkers (including white blood cells, the neutrophil ratio, interleukin-6, and C-reactive protein), time to first postoperative exhaust, time to first out-of-bed activity, postoperative length of hospital stay, cost of hospitalization, and incidence of postoperative complications.
RESULTS A total of 72 patients were enrolled and randomly divided into 2 groups: The mSLAN group (n = 36) and the CLA group (n = 36). The 24-hour VAS scores, 24-hour postoperative inflammatory response marker levels, first postoperative exhaust times, first out-of-bed activity times, postoperative lengths of hospital stay, operative times, or hospitalization costs did not significantly differ between the two groups. No postoperative complications, including incision infection or hernia, abdominal abscess or intestinal obstruction, were observed during the 1-month postoperative follow-up in either group.
CONCLUSION Compared with the CLA protocol, the mSLAN protocol for acute uncomplicated appendicitis yielded comparable short-term clinical outcomes, with a similar operative time and better cosmetic outcomes, indicating its potential for clinical application and superiority for patients with high cosmetic requirements. Further research is needed to evaluate the long-term outcomes.
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Affiliation(s)
- Yang Chen
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China
| | - Shi-Gang Guo
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China
| | - Xin-Ao Fu
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China
| | - Zong-Qi Fan
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China
| | - Jie-Qing Yuan
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China
| | - Xiao-Xin Zhang
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China
| | - Huan Liu
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China
| | - Zhu Liu
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China
| | - Yong-Shuai Huang
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China
| | - Lei Song
- Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China
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Li Q, Liu T, Qin T. Cholangioscope-Assisted Endoscopic Retrograde Appendicitis Therapy in the Management of Chronic Abdominal Pain Related to the Appendix: A Single-Center Retrospective Study. Dig Dis Sci 2025; 70:1126-1131. [PMID: 39885051 PMCID: PMC11920303 DOI: 10.1007/s10620-024-08795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 12/07/2024] [Indexed: 02/01/2025]
Abstract
BACKGROUND The diagnosis and treatment of chronic abdominal pain related to the appendix have always been challenging. In the past, an appendectomy was the main approach for suspected chronic abdominal pain related to the appendix, but there was an associated risk of negative appendectomy. In recent years, cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT) has been used to view the appendiceal cavity directly for flushing, stone removal, biopsy, and other operations, thereby achieving precise treatment. AIMS The aim of this study was to investigate the safety and efficacy of cholangioscope-assisted ERAT in the management of chronic abdominal pain related to the appendix. METHODS We evaluated 60 patients with chronic abdominal pain related to the appendix between January 2023 and January 2024, all of whom underwent cholangioscope-assisted endoscopic retrograde appendicitis therapy. The success rate (technical and clinical), procedure time, visual analog scale (VAS) score, length of hospital stay, and complication rate were recorded and analyzed. RESULTS The technical success rate of cholangioscopy was 100%, and the clinical success rate was 90%. The mean procedure time was 5.4 ± 1.9 min (standard deviation [SD]). The abdominal pain score at the mean follow-up time of 6.6 ± 1.4 months after the procedure was 0 (VAS method) in 90% of the patients. The average length of hospital stay was 2.1 ± 0.7 days. No adverse events occurred. CONCLUSION Cholangioscope-assisted endoscopic retrograde appendicitis therapy appears to be an effective novel therapy for chronic abdominal pain related to the appendix.
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Affiliation(s)
- Qianlong Li
- The First Ward of Gastroenterology, Digestive Disease Center, Suining Central Hospital, No. 27, Dongping North Road, Suining, 629000, China.
| | - Tianyu Liu
- The First Ward of Gastroenterology, Digestive Disease Center, Suining Central Hospital, No. 27, Dongping North Road, Suining, 629000, China
| | - Ting Qin
- Infectious Diseases Department, Suining Central Hospital, Suining, Sichuan, China
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Selvaggi L, Pata F, Pellino G, Podda M, Di Saverio S, De Luca GM, Sperlongano P, Selvaggi F, Nardo B. Acute appendicitis and its treatment: a historical overview. Int J Colorectal Dis 2025; 40:28. [PMID: 39881071 PMCID: PMC11779765 DOI: 10.1007/s00384-024-04793-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2024] [Indexed: 01/31/2025]
Abstract
PURPOSE Acute appendicitis (AA) is the leading cause of acute abdomen worldwide, with an incidence of 90-100 cases per 100,000 individuals annually and a lifetime risk of 7-12%. Despite its prevalence, historical accounts of AA are limited, particularly when compared to conditions like haemorrhoids, likely due to the appendix's internal location. This article traces the historical evolution of AA treatment from ancient times to the present, highlighting key contributions. METHODS A review of common research databases and relevant literature on AA was conducted. RESULTS Evidence from ancient Egypt suggests early recognition of the appendix, referring to it as the "worm of the bowel." However, detailed anatomical descriptions and treatment approaches for AA did not emerge until the Renaissance, particularly with contributions from Leonardo da Vinci and Berengario da Carpi. The article traces the progression of AA management, including the first autopsies and surgeries, the development of surgical techniques predating anaesthesia and antisepsis, and advancements achieved from the nineteenth to the twenty-first century. The shift from conservative to surgical approaches is discussed, alongside innovations such as laparoscopic appendicectomy, single-incision laparoscopic surgery (SILS), natural orifice transluminal endoscopic surgery (NOTES), and endoscopic retrograde appendicitis therapy (ERAT). The impact of the COVID-19 pandemic on AA treatment, including adaptations in medical practices, is also explored. CONCLUSIONS This review highlights the significant historical developments in AA treatment and its pivotal role in advancing abdominal surgery.
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Affiliation(s)
- Lucio Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Pata
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy
- Department of Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Salomone Di Saverio
- Department of Surgery, "Madonna del Soccorso" Hospital, San Benedetto del Tronto, Italy
| | - Giuseppe Massimiliano De Luca
- Unit of Endocrine, Digestive and Emergency Surgery, Department of Biomedical Sciences and Human Oncology, University Medical School "A. Moro" of Bari, Bari, Italy
| | - Pasquale Sperlongano
- Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy
| | - Bruno Nardo
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
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Hougaard ES, Møller LK, Kristensen SAR, Høyer ME, Ellebaek MB, Al-Najami I. Patient reported outcomes after laparoscopic appendectomy for acute appendicitis. Langenbecks Arch Surg 2024; 410:15. [PMID: 39718656 DOI: 10.1007/s00423-024-03584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Accepted: 12/16/2024] [Indexed: 12/25/2024]
Abstract
PURPOSE The purpose of this study is to establish more evidence to provide the clinicians with a greater knowledge on the patient reported outcomes and quality of life (QoL) after laparoscopic appendectomy (LA). METHOD 105 patients who had undergone LA for acute appendicitis regardless of severity, were included prospectively at Odense University Hospital, Svendborg. The patient reported consequence of surgery were assessed through the validated electronic survey from European-QoL questionnaire (5Q-5D-5L) including a self-reported VAS-score (0-100). The first survey was sent out the first day after surgery and the subsequent surveys at 7, 30 and 90 days. The replies was converted into an index-score expressing the QoL from 0 (death) to 1 (full health). RESULTS All patients experienced pain/discomfort at day 1. At day 7, 30 and 90 it was 95%, 45% and 25%, respectively. The median index-score at day 1, 7, 30 and 90 was 0.778, 0.840, 0.984 and 1.00, respectively.
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Affiliation(s)
- Emilie Schultz Hougaard
- Department of Surgery, Odense University Hospital, Odense, Denmark.
- Research Unit of Surgery, Odense University Hospital, Odense, Denmark.
- Department of Surgery, Odense University Hospital, Baggoes Alle 31, Svendborg, 5700, Denmark.
| | - Lasse Kaalby Møller
- Department of Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Research Unit of Surgery, Odense University Hospital, Odense, Denmark
| | | | - Mai Elizabeth Høyer
- Department of Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Research Unit of Surgery, Odense University Hospital, Odense, Denmark
| | - Mark Bremholm Ellebaek
- Department of Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Research Unit of Surgery, Odense University Hospital, Odense, Denmark
| | - Issam Al-Najami
- Department of Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Research Unit of Surgery, Odense University Hospital, Odense, Denmark
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Zhang A, Fan N, Zhang X, Guo H, Zhou Y, Zeng L, Lin Y, Jiang X. Endoscopic retrograde appendicitis therapy. Therap Adv Gastroenterol 2024; 17:17562848241275314. [PMID: 39372040 PMCID: PMC11450793 DOI: 10.1177/17562848241275314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/26/2024] [Indexed: 10/08/2024] Open
Abstract
Endoscopic retrograde appendicitis therapy (ERAT) is a novel and minimally invasive technological alternative for the management of acute or chronic appendicitis. Through endoscopic appendiceal intubation, obstructions such as appendiceal feces and parasites within the appendiceal lumen can be effectively eliminated, leading to patient recovery. Additionally, in cases where the orifices are swollen or complicated appendicitis is present, a stent may be inserted following appendiceal flushing. Due to the utilization of endoscopy for accessing the orifices of the appendix in order to alleviate appendiceal obstruction, patients were able to avoid undergoing appendectomy and experienced a reduced likelihood of recurrence when compared to antibiotic therapy. Additionally, the ERAT provided alternative options for individuals with appendicitis and comorbidities. Recent advancements in techniques, such as the "mother-baby" endoscopic system and the use of microbubble contrast agents, have expanded the range of indications and the eligible patient populations. The objective of this review is to present a comprehensive overview of the development, procedural aspects, therapeutic principles, treatment efficacy, therapeutic applications, and potential complications associated with ERAT.
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Affiliation(s)
- Anding Zhang
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Na Fan
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Xinhui Zhang
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Hongwei Guo
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Ying Zhou
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Lingchao Zeng
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Yan Lin
- Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, Shaanxi, China
| | - Xun Jiang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), No. 1 Xinsi Road, Xi’an, Shaanxi 710038, China
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Feng SJ, Zhou YF, Yang JF, Shen HZ, Cui GX, Zhang XF. Is appendoscope a new option for the treatment of acute appendicitis? World J Gastroenterol 2024; 30:3386-3392. [PMID: 39091716 PMCID: PMC11290393 DOI: 10.3748/wjg.v30.i28.3386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 06/11/2024] [Accepted: 07/01/2024] [Indexed: 07/24/2024] Open
Abstract
Acute appendicitis is a common surgical emergency. It is commonly caused by obstruction of the appendiceal lumen due to fecaliths, tumors, or lymphoid hyperplasia. For over a century, appendectomy has been the primary treatment for acute appendicitis. Abraham Groves performed the first open appendectomy in 1883. In 1983, Kurt Semm completed the first laparoscopic appendectomy, heralding a new era in appendectomy. However, appendectomy is associated with certain complications and a rate of negative appendectomies. Studies have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson's disease, but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer, gallstones, and cardiovascular disease. With the recognition that the appendix is not a vestigial organ and the advancement of endoscopic te-chnology, Liu proposed the endoscopic retrograde appendicitis therapy. It is an effective minimally invasive alternative for treating uncomplicated acute appendicitis. Our team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of appendicitis. This article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.
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Affiliation(s)
- Shu-Jiong Feng
- Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Hangzhou Institute of Digestive Diseases, Hangzhou 310000, Zhejiang Province, China
| | - Yi-Feng Zhou
- Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Hangzhou Institute of Digestive Diseases, Hangzhou 310000, Zhejiang Province, China
| | - Jian-Feng Yang
- Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Hangzhou Institute of Digestive Diseases, Hangzhou 310000, Zhejiang Province, China
| | - Hong-Zhang Shen
- Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Hangzhou Institute of Digestive Diseases, Hangzhou 310000, Zhejiang Province, China
| | - Guang-Xing Cui
- Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Hangzhou Institute of Digestive Diseases, Hangzhou 310000, Zhejiang Province, China
| | - Xiao-Feng Zhang
- Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
- Department of Gastroenterology, Hangzhou Institute of Digestive Diseases, Hangzhou 310000, Zhejiang Province, China
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Liu D, Zhang J, Liu B. Endoscopic retrograde appendicitis therapy: current and the future. Gastroenterol Rep (Oxf) 2024; 12:goae037. [PMID: 38887595 PMCID: PMC11181945 DOI: 10.1093/gastro/goae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 06/20/2024] Open
Abstract
This article presents an overview of endoscopic retrograde appendicitis therapy (ERAT), an innovative and minimally invasive treatment for appendicitis with an appendix-preserving manner. Since its initial application in 2009, ERAT has gained significant popularity in China, due to its rapid recovery and minimal risk of complications. The ERAT procedures comprise several steps, including appendiceal orifice access and intubation, appendiceal lumen imaging, decompression and irrigation, fecalith removal, and stenting. ERAT has been used in various forms of complicated appendicitis, such as in pregnant women and children, with continuous improvements in both technique and safety. It has the potential to become the preferred diagnostic and treatment method for appendicitis. Until 2023, over 10,000 ERAT procedures have been successfully conducted in China, and the technique has gained more attention worldwide. However, challenges remain, including training, standardization of ERAT practice, research and technology improvement, enhancing public awareness, and fostering international collaboration. In summary, ERAT can be the standard treatment for appendicitis treatment, which represents a paradigm shift in the conventional clinical practice.
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Affiliation(s)
- Dan Liu
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jiyu Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Bingrong Liu
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
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Suarez ZK, Samhoun J, Drourr J, Nagi T, Haider MA, Vallejo C, Touqir Z, Forcione D. Successful Endoscopic Retrograde Appendicitis Therapy Following a Recent ST-Elevation Myocardial Infarction. ACG Case Rep J 2024; 11:e01324. [PMID: 38560012 PMCID: PMC10980388 DOI: 10.14309/crj.0000000000001324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Acute appendicitis is one of the most common abdominal surgical emergencies. A laparoscopic or open appendectomy has traditionally been the gold standard. Antibiotic therapy has recently been found to be noninferior. The treatment of acute uncomplicated appendicitis remains a challenge, especially in the presence of an appendicolith. We present a case of a 59-year-old man with recent ST-elevation myocardial infarction who underwent successful endoscopic retrograde appendicitis therapy.
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Affiliation(s)
- Zoilo K. Suarez
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - Jalal Samhoun
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - Joshua Drourr
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - Talwinder Nagi
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - Muhammad A. Haider
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - Charles Vallejo
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - Zahra Touqir
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | - David Forcione
- Internal Medicine Department, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
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