Post-colonoscopy Appendicitis: A Literature Review and Guidelines for Management

Area of Science:

• Gastroenterology
• Surgical Complications
• Diagnostic Medicine

Background:

• Post-colonoscopy appendicitis is an underrecognized complication.
• Lack of clinical guidelines hinders early diagnosis.
• Nonspecific symptoms often mask this rare condition.

Purpose of the Study:

• To synthesize evidence on post-colonoscopy appendicitis.
• To propose a structured approach for early recognition.
• To address the diagnostic gap for this rare complication.

Main Methods:

• Comprehensive literature search (PubMed, Embase, Google Scholar) from 1980-2024.
• Screening of 74 abstracts, with 21 articles selected for full-text review.
• Synthesis of data on incidence, mechanisms, presentation, diagnosis, and treatment.

Main Results:

• Estimated incidence of 3.8-4.9 cases per 10,000 colonoscopies.
• Most cases present within 48 hours with RLQ pain, fever, and leukocytosis.
• Proposed mechanisms include pressure, barotrauma, fecalith displacement, and trauma.

Conclusions:

• Acute appendicitis should be considered in post-colonoscopy abdominal pain.
• A structured clinical approach aids early recognition and timely management.
• Increased awareness and prompt imaging can improve patient outcomes.