title: Acute appendicitis following endoscopic mucosal resection of cecal adenoma.
abstract: Endoscopic mucosal resection (EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right -lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm(3), a neutrophil count of 14144/mm(3), and a C-reactive protein level of 2.20 mg/dL, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis.
authors.affiliation: Yukako Nemoto, Junya Tokuhisa, Nagasato Shimada, Iruru Maetani, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Nemoto
authors.affiliation: Yukako Nemoto, Junya Tokuhisa, Nagasato Shimada, Iruru Maetani, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Tokuhisa
authors.affiliation: Yukako Nemoto, Junya Tokuhisa, Nagasato Shimada, Iruru Maetani, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan.
authors.forename: Nagasato
authors.initials: N
authors.lastname: Shimada
authors.affiliation: Yukako Nemoto, Junya Tokuhisa, Nagasato Shimada, Iruru Maetani, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Gomi
authors.affiliation: Yukako Nemoto, Junya Tokuhisa, Nagasato Shimada, Iruru Maetani, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan.
authors.forename: Iruru
authors.initials: I
authors.lastname: Maetani
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000900:Anti-Bacterial Agents; D001064:Appendicitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002430:Cecal Neoplasms / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute appendicitis; Antibiotics; Cecal adenoma; Computed tomography; Endoscopic mucosal resection