title: Endoscopic retrograde appendicitis therapy: a pilot minimally invasive technique (with videos).
abstract: BACKGROUND
  Inspired by the success of ERCP for the treatment of suppurative cholangitis, we investigated a new minimally invasive method for the treatment of acute uncomplicated appendicitis, which we call endoscopic retrograde appendicitis therapy.
  
  
  OBJECTIVE
  To investigate the feasibility and efficacy of endoscopic retrograde appendicitis therapy for the treatment of acute uncomplicated appendicitis.
  
  
  METHODS
  A retrospective, single-center study at an academic medical center.
  
  
  METHODS
  Four patients with acute uncomplicated appendicitis.
  
  
  METHODS
  There were 5 steps after insertion of a colonoscope into the cecum and identification of the appendiceal orifice: (1) endoscopic appendiceal intubation; (2) appendiceal decompression; (3) retrograde appendicography; (4) stent drainage; and (5) cleansing the appendiceal lumen.
  
  
  METHODS
  The rate of successful endoscopic intubation and decompression, the time to symptom relief, the time to disappearance of signs, increased white blood cell count, procedure-related complications, and recurrence, if any.
  
  
  RESULTS
  All 4 endoscopic appendiceal intubations were successful. Pain was relieved immediately after endoscopic decompression and stent drainage. Leukocytosis returned to normal within 24 hours. There were no complications and no recurrences during 4 to 19 months of follow-up.
  
  
  CONCLUSIONS
  Small sample size, single-center study without controls.
  
  
  CONCLUSIONS
  Endoscopic retrograde appendicitis therapy is a feasible and effective endoscopic treatment modality for acute uncomplicated appendicitis.
authors: Digestive Endoscopy Center, Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China. 13704510648@126.com
authors: Bing-Rong
authors: BR
authors: Liu
authors: Ji-Tao
authors: JT
authors: Song
authors: Fu-You
authors: FY
authors: Han
authors: Hui
authors: H
authors: Li
authors: Ji-Bin
authors: JB
authors: Yin
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging / Q000628:therapy*; D002648:Child; D020685:Colonoscopes; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult