Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.106587
Revised: April 6, 2025
Accepted: May 26, 2025
Published online: September 6, 2025
Processing time: 116 Days and 17.4 Hours
Endoscopic retrograde appendicitis therapy (ERAT) is an emerging technique. However, its efficacy remains uncertain, and postoperative complications often exacerbate inflammation, thereby increasing the difficulty of surgery. The use of ERAT in appendicitis remains contentious, prompting the presentation of this case report.
We report the case of a 43-year-old female patient presenting with intermittent right lower abdominal pain for one day. The patient had undergone ERAT six months previously. Examination revealed stent impaction in the appendix, leading to exacerbated inflammation. Subsequently, a solo single-incision laparoscopic appendectomy (SSLA) was performed. The ERAT-related complications increased surgical difficulty and prolonged the operation time. Post-SSLA, the patient was hospitalized for one day and showed favorable recovery upon follow-up.
This case highlights the risks of ERAT. Thorough preoperative assessment, proper stent placement during surgery and regular postoperative follow-up are crucial in preventing complications, as their occurrence can increase surgical difficulty. Compared to ERAT, SSLA remains more widely used in clinical practice. Both techniques require further clinical data and research to optimize their application.
Core Tip: We report the case of appendicitis where post-endoscopic retrograde appendicitis therapy (ERAT) stent impaction worsened inflammation. Ultimately, the novel solo single-incision laparoscopic appendectomy (SSLA) technique successfully removed the appendix. As ERAT is still in its early stages, inadequate technical proficiency, postoperative complications and improper postoperative management can exacerbate the patient's condition and increase surgical difficulty. This case prompts further reflection on the choice between ERAT and SSLA, encouraging the refinement of both techniques. This report emphasizes the importance of preoperative assessment, stent placement, and postoperative management for ERAT, while confirming SSLA's advantages in addressing ERAT complications and healing appendicitis.