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Post-colonoscopy appendicitis: A systematic review.

Kostas Tepelenis¹, Christos K Stefanou², Stefanos K Stefanou²

¹Department of Surgery, General Hospital of Ioannina "G. Xatzikosta", Ioannina, Greece.

Asian Journal of Surgery

|September 5, 2024

Summary

Post-colonoscopy appendicitis is a rare complication. Early recognition of symptoms like pain and fever after a colonoscopy is crucial for timely diagnosis and effective management, often involving surgery.

Keywords:

Appendicitis after colonoscopy Appendicitis complicating colonoscopy Appendicitis following colonoscopy Post-colonoscopy appendicitis

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Area of Science:

Gastroenterology
Surgical Complications
Diagnostic Imaging

Background:

Post-colonoscopy appendicitis is an infrequent but significant complication following the procedure.
Understanding its clinical features and management is essential for patient care.

Purpose of the Study:

To systematically review and synthesize current literature on post-colonoscopy appendicitis.
To delineate clinical presentations, diagnostic methods, and treatment strategies.

Main Methods:

Systematic literature search of PubMed and Embase databases up to December 31, 2023.
Inclusion of 56 articles detailing 67 patient cases.
Data abstraction by two independent reviewers.

Main Results:

Median patient age was 54.9 years, with a male predominance (64.2%).
Most patients (79.1%) presented within two days post-colonoscopy.
Diagnosis confirmed in 70.2% via CT or ultrasound; 88.1% treated surgically, primarily appendectomy.

Conclusions:

Post-colonoscopy appendicitis, though rare, necessitates clinical suspicion with characteristic symptoms.
Prompt diagnosis and appropriate management, predominantly surgical, lead to satisfactory outcomes.
Histopathology frequently revealed acute or complicated appendicitis, with fecalith noted in 31.3%.