Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2025; 13(25): 106587
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.106587
Post-endoscopic retrograde appendicitis therapy stent impaction leading to exacerbation of appendicitis: A case report
Tan-Tu Ma, Hao-Run Lyu
Tan-Tu Ma, Department of Hepatobiliary Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
Hao-Run Lyu, Department of Emergency Surgery, Peking University People’s Hospital, Beijing 100044, China
Author contributions: Ma TT contributed to manuscript writing and editing; Lyu HR contributed to conceptualization and supervision and data collection; all authors have read and approved the final manuscript.
Supported by National Key R and D Program of China-Key Special Project on Diagnostic and Therapeutic Equipment and Biomedical Materials, No. 2023YFC2412005.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
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: Hao-Run Lyu, MD, Department of Emergency Surgery, Peking University People’s Hospital, No. 11th Xizhimen South Street, Beijing 100044, China. lvhaorun5@sina.com
Received: March 13, 2025
Revised: April 6, 2025
Accepted: May 26, 2025
Published online: September 6, 2025
Processing time: 116 Days and 17.4 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Appendicitis; Appendiceal fecaliths; Endoscopic retrograde appendicitis therapy; Solo single-incision laparoscopic appendectomy; Stent impaction; Case report

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.