An Unusual Cause of Abdominal Pain

Abstract

Question: A 53-year-old woman with a history of hypertension and nephrolithiasis presents with right lower quadrant nonradiating abdominal cramping. The patient underwent a screening colonoscopy the day prior with a 6-mm sessile polyp removed from the cecum via cold snare polypectomy. The abdominal pain started 12 hours after the colonoscopy and was associated with nausea and tactile fevers. She denied hematochezia or a change in bowel habits. On physical examination, she was febrile (38.8 C) and hemodynamically stable. The abdomen was soft with tenderness to palpation in the right lower quadrant without peritoneal signs. Laboratory values were significant for a white blood cell count 7.0 K/mL (reference range, 4.5-11.0 K/mL). A computed tomography scan of the abdomen was also completed (Figure A). What is the diagnosis? See the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.

Post‐colonoscopy appendicitis: Systematic review of current evidence

“…All the cases are summarized in Table 1. [4][5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]30,[32][33][34][35][36][38][39][40][41][42][43][44][45][46][47][48]…”

“…Twenty‐nine patients required appendectomy (seven cases by laparoscopy); two were managed successfully with intravenous antibiotics. All the cases are summarized in Table 1 4–7,9–28,30,32–36,38–48 …”

Postcolonoscopy Appendicitis: A Review of 57 Cases

“…Thirty-four publications were retrieved from "PubMed," "EMBASE," and "Scopus," and further 10 publications from "Google scholar" which were not indexed in either "PubMed," "EMBASE" or "Scopus." [46][47][48][49][50][51][52][53][54][55] Four additional articles were identified through manual search. 8,10,46,56 The total number of publications and cases reported are shown in Figure 2.…”