Post‐colonoscopy appendicitis: Systematic review of current evidence

Ng, Zi Qin; Elsabagh, Abdallah; Wijesuriya, Ruwan

doi:10.1111/jgh.15130

Cited by 15 publications

(27 citation statements)

References 41 publications

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“…The entity of post-colonoscopy appendicitis is likely to share some similarities in its pathogenesis[ 17 ]. Various theories have been postulated for its mechanism: Barotrauma secondary to insufflation, inadvertent intubation of the diverticulum, faecolith introduction or propagation during the procedure leading to inflammation and exacerbation of subclinical/chronic disease.…”

Section: Discussionmentioning

confidence: 99%

Post-colonoscopy diverticulitis: A systematic review

Tan

et al. 2021

WJGE

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BACKGROUND Post-colonoscopy diverticulitis is increasingly recognized as a potential complication. However, the evidence is sparse in the literature. AIM To systematically review all available evidence to describe the incidence, clinical course with management and propose a definition. METHODS The databases PubMed, EMBASE and Cochrane databases were searched using with the keywords up to June 2020. Additional manual search was performed and cross-checked for additional references. Data collected included demographics, reason for colonoscopy, time to diagnosis, method of diagnosis (clinical vs imaging) and management outcomes. RESULTS A total of nine studies were included in the final systematic review with a total of 339 cases. The time to diagnosis post-colonoscopy ranged from 2 h to 30 d. Clinical presentation for these patients were non-specific including abdominal pain, nausea/vomiting, per rectal bleeding and chills/fever. Majority of the cases were diagnosed based on computed tomography scan. The management for these patients were similar to the usual patients presenting with diverticulitis where most resolve with non-operative intervention ( i.e. , antibiotics and bowel rest). CONCLUSION The entity of post-colonoscopy diverticulitis remains contentious where there is a wide duration post-procedure included. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment. Further prospective studies especially registries should include this as a complication to try to capture the true incidence.

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Section: Discussionmentioning

confidence: 99%

Post-colonoscopy diverticulitis: A systematic review

Tan

et al. 2021

WJGE

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“…The time of diagnosis ranges from few hours to 10 days. The vast majority of patients is diagnosed within the first 48 h post-colonoscopy [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The main concern in all patients who experience pain after colonoscopy is perforation of the colon, primarily when polypectomy is carried out. Unfortunately, complications such as bowel perforation and post-polypectomy syndrome may mimic post-colonoscopy appendicitis [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Advantages of laparoscopic appendectomy encompass the shorter length of hospital stay, earlier return to normal activities, less postoperative pain, an earlier start of oral intake, and lower wound infections [ 14 , 15 ]. Another benefit of laparoscopy is the rapid scrutiny for evidence of bowel perforation, and if present, it can be easily converted to an exploratory laparotomy [ 7 ]. In lacking equipment or expertise surgeons, open appendectomy remains a safe and quick alternative [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Post-colonoscopy appendicitis: a case report

Tepelenis

Stefanou

et al. 2021

Journal of Surgical Case Reports

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Appendicitis after colonoscopy is rare, with an estimated incidence of 3.8 cases per 10 000 colonoscopies. Herein, we report a 56-year-old female who visited the emergency department with a history of diffuse abdominal pain and nausea 8 h after a screening colonoscopy. Abdominal examination disclosed deep tenderness at Mc Burney point and positive Rovsign’s sign. Laboratory studies revealed elevated white blood cells and neutrophils (WBC 15.37 K/Ul and NEUT 86.5%) with normal C-reactive protein (5 mg/l). The initial diagnosis was acute appendicitis, which was confirmed by the ultrasonographic findings. The patient was admitted to the surgical department, and a laparoscopic appendectomy was performed. Post-colonoscopy appendicitis is increasingly recognized as a complication after colonoscopy in the last decade. Early recognition is vital in preventing morbidity and mortality. It may also be worthwhile to include appendicitis after colonoscopy as a possible complication during the consent before the procedure.

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“…We read with great interest the article about post-colonoscopy appendicitis by Ng et al 1 The authors concluded, after performing a systematic review, that there is raised awareness of the entity "post-colonoscopy appendicitis" as an endoscopic complication over the last decade. Although a neutral position of the authors has to be acknowledged, there are concerns regarding the true causality of this association.…”

Section: To the Editormentioning

confidence: 99%