Intussusception of the Appendix: Another Poorly Recognized Cause of Rectal Bleeding

Gupta, Puneet; Chwals, Walter J.; Guandalini, Stefano

doi:10.1097/00005176-200003000-00021

Cited by 17 publications

(10 citation statements)

References 27 publications

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“…Acute bleeding from the vermiform appendix is thought to be one of the least common causes of LGIB. The causes have been reported diversely as diverticulitis,7 diverticulum,8 acute appendicitis,9,10 endometriosis,11 angiodysplasia,2,12 Crohn's disease,13,14 aortoappendiceal fistula,15 intussusceptions,16-19 Henoch-Schonlein purpura,20,21 gastrointestinal stromal tumor,22 ulcer,5 and erosion 6. Our search has found 20 cases that had all presented with LGIB in English-language literature.…”

Section: Discussionmentioning

confidence: 99%

Massive Lower Gastrointestinal Bleeding from the Appendix

Chung¹,

Gao²

2011

Gut Liver

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Massive rectal bleeding from the appendix, considered a rare case of lower gastrointestinal bleeding, is not easily recognized by various diagnostic modalities. A multidisciplinary approach for both a diagnosis and a differential diagnosis is important because the identification of the bleeding site is crucial to proceed to a proper intervention and there are various causes of appendiceal bleeding. Because early colonoscopy plays an important role in the diagnosis and management of lower gastrointestinal hemorrhage, we report a case of a life threatening massive rectal bleeding from the appendix diagnosed by colonoscopy. We also present a review of the literature.

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Section: Discussionmentioning

confidence: 99%

Massive Lower Gastrointestinal Bleeding from the Appendix

Chung¹,

Gao²

2011

Gut Liver

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“…Sixteen patients were male, while the others were female. The causes of the bleeding included diverticulitis [1], Crohn’s disease [2,4,16], a mucinous cyst [6], aorta-appendix fistula [15], ectopic uterus mucosa [10], angiodysplasia [11,14], intussusceptions [3,8,9,13], gastrointestinal stromal tumor [20] and intestinal tuberculosis [21]. Anti-coagulation drugs were administered in 4 cases [5,17,20].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, in most cases with bleeding from the appendix, an emergency operation was necessary [1-13,15-22]. We herein report the first case of the bleeding associated with the appendix ulcer which was successively controlled by the administration of a therapeutic barium enema into the appendix.…”

Section: Introductionmentioning

confidence: 96%

A therapeutic barium enema is a practical option to control bleeding from the appendix

et al. 2013

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BackgroundAcute lower gastrointestinal hemorrhage originating from the appendix is rare and often intractable, because it is almost impossible to approach the bleeding point by endoscopy. We herein describe the first case of bleeding from the appendix, which was successively controlled by a therapeutic barium enema administered into the appendix.Case presentationA 71-year-old male visited our hospital because of melena. He has been receiving an anti-coagulation drug, ticlopidine hydrochloride, for 10 years. By an emergency colonoscopy, a hemorrhage was detected in the appendix, and the lesion responsible for the bleeding was regarded to exist in the appendix. Two hundred milliliters of 50 W/V% barium was sprayed into the orifice of the appendix using a spraying tube. The bleeding could thus be immediately stopped, and a radiological examination revealed the accumulation of barium at the cecum and the orifice of the appendix. The barium accumulation disappeared by the next day, and no obvious anal bleeding was observed. Two weeks after stopping the bleeding from the appendix, an appendectomy was performed to prevent any further refractory hemorrhaging. The patient has had no complaints of any abdominal symptoms or anal bleeding for 10 months.ConclusionsA therapeutic barium enema is a useful procedure to control bleeding from the appendix and to avoid emergency surgery, such as partial cecectomy and hemicolectomy.

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“…It was first reported in 1858 by Mc Kidd on a 7-year-old boy [3]. In a large screening of 71,000 appendiceal specimens, the incidence was 0.01% [1]; 50% of pediatric cases occur in patients younger than 10 years and occurs 4 to 5 times more frequently in boys [1,[3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal appendiceal peristalsis caused by local irritation is believed to be the main factor. Pathological conditions such as worms, fecaliths, foreign bodies, polyps, mucoceles, and tumors have been suggested as local irritants, whereas anatomical factors such as mobile cecum, a wide appendiceal lumen, and a thin mesoappendix with narrow base have also been proposed [1,5,6,8].…”

Section: Discussionmentioning

confidence: 99%