Apendicite aguda pós colonoscopia: desafio diagnóstico e tratamento minimamente invasivo - relato de caso

Abstract

We present a case of a 54-year-old man with abdominal pain four hours after colonoscopy and upper endoscopy. Since he had had a polipectomy and an ulcer was seen in the terminal ileum, the diagnosis of appendicitis was even more difficult. The authors discuss the rarity of this situation and the minimally invasive approach to treat appendicitis.

Post-Colonoscopy Appendicitis: A Rare Entity

“…Among reported cases, average age was 54.4 years, the male:female ratio was 10:1 and the onset of symptoms ranges between 12 h to five days. 8 In our case, although the patient presented on Day 7 post procedure the onset of symptoms was Day 4 following the colonoscopy. Possible explanations for post-colonoscopy appendicitis are: direct intubation of appendicular lumen, local edema and obstruction of the appendicular lumen secondary to mucosal injury around the appendiceal orifice, barotrauma, penetration of fecolith inside the lumen, pumped through the colonoscope, and pre-existing sub-clinical disease of the appendix.…”

“…Waye et al 1 and Kavic and Basson 2 listed the rare complications of colonoscopy. They include mesenteric ischemia, cholecystitis, pancreatitis, appendicitis, 3–8 small bowel perforation, volvulus, obstruction and strangulation.…”

Diagnostic Colonoscopy Leading to Perforated Appendicitis: A Case Report and Systematic Literature Review

“…Exploratory laparotomy was the main form of operation in cases of diffuse inflammation; however, laparoscopic procedures have relatively recently been introduced and used in cases of perforated appendicitis [23, 27, 31] with good postoperative results.…”