Therapeutic Advances in Gastroenterology (Sep 2024)

Endoscopic retrograde appendicitis therapy

  • Anding Zhang,
  • Na Fan,
  • Xinhui Zhang,
  • Hongwei Guo,
  • Ying Zhou,
  • Lingchao Zeng,
  • Yan Lin,
  • Xun Jiang

DOI
https://doi.org/10.1177/17562848241275314
Journal volume & issue
Vol. 17

Abstract

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Endoscopic retrograde appendicitis therapy (ERAT) is a novel and minimally invasive technological alternative for the management of acute or chronic appendicitis. Through endoscopic appendiceal intubation, obstructions such as appendiceal feces and parasites within the appendiceal lumen can be effectively eliminated, leading to patient recovery. Additionally, in cases where the orifices are swollen or complicated appendicitis is present, a stent may be inserted following appendiceal flushing. Due to the utilization of endoscopy for accessing the orifices of the appendix in order to alleviate appendiceal obstruction, patients were able to avoid undergoing appendectomy and experienced a reduced likelihood of recurrence when compared to antibiotic therapy. Additionally, the ERAT provided alternative options for individuals with appendicitis and comorbidities. Recent advancements in techniques, such as the “mother–baby” endoscopic system and the use of microbubble contrast agents, have expanded the range of indications and the eligible patient populations. The objective of this review is to present a comprehensive overview of the development, procedural aspects, therapeutic principles, treatment efficacy, therapeutic applications, and potential complications associated with ERAT.