Intraluminal endoscopic removal of the appendix after intravaginal appendectomy in a 9-year-old child



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Introduction. Appendix invertus is a rare condition in which the appendix is invaginated into the cecum lumen. This pathology has a wide spectrum of clinical manifestations ranging from asymptomatic course to severe inflammation.

Purpose. To describe the first clinical experience in pediatric practice of successful appendix removal using flexible intraluminal endoscopy.

Material and methods. A clinical case of a 9-year-old female patient who was admitted to Irkutsk Municipal Pediatric Clinical Hospital was analyzed. On admission, the patient had clinical signs of acute abdomen with a history of previous appendectomy performed by the “invagination” technique. Based on the hypothesis, that the inverted appendix is in the intestinal lumen, it was decided to perform appendectomy with flexible intraluminal endoscopy.

Results. It has been demonstrated that intraluminal endoscopy in pediatrics may be applied in rare clinical situations; in our case, it was necessary to remove the inverted appendix.

Conclusion. Flexible intraluminal endoscopy is a curative modality which illustrates the progress in improvement and expansion of indications and techniques in the area of NOTES surgery.

About the authors

N. M. Stepanova

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital; Irkutsk State Medical University

Author for correspondence.
Email: sergiklee@mail.ru

М. Stepanova, MD, Cand.Sc.(med), аssociate professor at chair of pediatric surgery; pediatric surgeon

Irkutsk, 664009, Russian Federation

Irkutsk, 664003, Russian Federation

Россия

I. S. Sharapov

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Россия

D. A. Zvonkov

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Россия

M. N. Mochalov

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital; Irkutsk State Medical University

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Irkutsk, 664003, Russian Federation

Россия

E. M. Petrov

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Россия

N. I. Mikhailov

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Россия

D. S. Grigoriev

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Россия

T. S. Artemieva

Ivano-Matreninskaya Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru

Irkutsk, 664009, Russian Federation

Россия

References

  1. Edebohls G.M. Inversion of the vermiform appendix. Am J Med Sci. 1895; 109: 650-3.
  2. Vaughn A.M., Widran J. Inverted appendical stump simulating cancer of the cecum. J Am Med Assoc. 1954; 154 (12): 996-7.
  3. Järvensivu P., Lehtola J., Karvonen A.L., Rinne A., Suramo I. Colonoscopic appearance of the remnant of the appendix after total inversion. Endoscopy. 1982; 14: 66–8.
  4. Navarra G., Asopa V., Basaglia E., Jones M., Jiao L., Habib N. Mucous cystadenoma of the appendix: is it safe to remove it by a laparoscopic approach. Surg Endosc. 2003; 17(5): 833–4.
  5. Johnson E.K., Arcila M.E., Steele S.R. Appendiceal inversion: a diagnostic and therapeutic dilemma. JSLS. 2009; 13(1): 92–5.
  6. Александров С.В., Баиров А.Г., Баиров В.Г., Баранов А.А., Кашин А.С., Козлов В.П., Листратов С.М., Сигунов В.С. – аппендикулярный перитонит у детей. Детская хирургия. 2019; 23(1, Приложение): 11.
  7. Engström L. Fenyö G. Appendicectomy: assessment of stump invagination versus simple ligation. a prospective, randomized trial. Br J Surg. 1985; 72 (12): 971-2.
  8. Järvensivu P., Lehtola J., Karvonen A.L., Rinne A., Suramo I. Colonoscopic appearance of the remnant of the appendix after total inversion. Endoscopy. 1982; 14 (2): 66-8.
  9. Myllärniemi H., Perttala Y., Peltokallio P. Tumor-like lesions of the cecum following inversion of the appendix. Am J Dig Dis. 1974; 19 (6): 547-56.
  10. Pickhardt P.J. Differential diagnosis of polypoid lesions seen at CT colonography (virtual colonoscopy). Radiographics. 2004; 24 (6): 1535-59.
  11. Lilly J.R., Randolph J.G. Total inversion of the appendix: experience with incidental appendectomy in children. J Pediatr Surg. 1968; 3: 357-63.
  12. Burchard P.R., Thomay A.A.Appendiceal intussusception in the setting of ulcerative colitis. J Surg Case Rep. 2018; 2018(4): rjy044.
  13. Hood P.A. Intussusception in infants and children. J Irish Med Ass. 1967; LX: 13.
  14. Johnson E.K., Arcila M.E., Steele S.R.. Appendiceal inversion: a diagnostic and therapeutic dilemma. JSLS. 2009; 13(1): 92–5.
  15. Fazio R.A., Wickremesinghe P.C., Arsura E.L., Rando J. Endoscopic removal of an intussuscepted appendix mimicking a polyp – an endoscopic hazard. Am J Gastroenterol. 1982 Aug; 77(8): 556-8.
  16. Tran C., Sakioka J., Nguyen E., Beutler B.D., Hsu J. An inverted appendix found on routine colonoscopy: A case report with discussion of imaging findings. Radiol Case Rep. 2019; 14(8): 952–5.
  17. Enander L.K., Gustavsson S. Colonoscopic appendectomy. Acta Chir Scand. 1979; 145(8): 575–6.
  18. Лохматов М.М., Будкина Н.Н, Олдаковский В.И., Тупыленко А В., Ибрагимов С.И. Внутрипросветная эндоскопия у детей – прошлое, настоящее, будущее” Российский педиатрический журнал. 2018; 21(4): 230-6.
  19. Byoung Y.R. et al. Colonoscopic Diagnosis of Appendiceal Intussusception: A Case Report. J Korean Med Sci. 2005; 20: 680-2.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c)

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies