One year follow up outcomes of endoscopic retrograde appendicitis treatment for symptomatic appendicoliths

Symptomatic appendicoliths may cause recurrent abdominal pain or distension, but appendix-preserving treatment options are limited. We retrospectively evaluated endoscopic retrograde appendicitis treatment (ERAT) in 78 patients with CT- or ultrasound-confirmed appendicoliths. Symptoms were assessed using a modified abdominal pain or distension questionnaire (APQ), and outcomes were evaluated separately in adults and minors. APQ scores decreased at 1 week, 1 month, 6 months, and 1 year after ERAT. At 1 year, complete remission was achieved in 37 of 47 adults (78.7%) and 27 of 31 minors (87.1%). Multivariable Cox regression identified disease duration longer than 3 months and fecalith lumps as predictors of incomplete remission in adults, whereas NLR > 1.87 was inversely associated with this outcome. ERAT may provide sustained symptom relief while preserving the appendix, although prospective multicenter controlled studies are needed.