Intussusception of the appendix is an uncommon condition, and the diagnosis is rarely
made preoperatively, although the condition may be suspected on the basis of radiological
studies and colonoscopy [1]. Colonoscopy may in fact be the procedure of choice for both diagnosis and for selecting
the appropiate course of management [2]. We report a case in which an intussusception of the appendix was resected colonoscopically.
A 41-year-old woman presented with a 4-day history of rectal tenesmus, diarrhea, and
recurrent severe paroxysmal abdominal pain. Colonoscopy examination revealed an intussusception
of the appendix (Figure [1]). In this case a colonoscopic appendectomy was performed succesfully with the use
of an endoloop ligating system (MAJ-254, HX-20L/Q/U-1; Olympus, Hamburg, Germany).
The endoloop was attached over the appendix and then an appendectomy was succesfully
performed with a polypectomy snare wire (Figure [2]). The pathology report confirmed the diagnosis of intussusception of the appendix
and the patient made a satisfactory recovery without complications. Colonoscopy should
therefore be considered as an excellent choice of treatment in such cases and should
be remembered as a second option in patients in whom laparoscopic treatment fails
to lead to resolution of the condition.
Figure 1 Colonoscopic view showing an intussusception of the appendix.
Figure 2 The intussusception was resected endoscopically using an endoloop, seen here over
the cecum after the appendectomy.
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