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Case Reports
. 2024 Jul 12;11(7):e01430.
doi: 10.14309/crj.0000000000001430. eCollection 2024 Jul.

SpyGlass/Cholangioscope-Assisted Colonoscopic Removal of Appendicolith as a Nonsurgical Alternative for Stump Appendicitis Management

Aarushi Sudan  1 , Dhawani Julka  2 , Sunny A Patel  3
Affiliations
Case Reports

SpyGlass/Cholangioscope-Assisted Colonoscopic Removal of Appendicolith as a Nonsurgical Alternative for Stump Appendicitis Management

Aarushi Sudan et al. ACG Case Rep J. .

Abstract

An appendicolith is a calcified mass which can obstruct the appendix often leading to recurrent appendicitis. Failure to extract fecalith at the time of appendectomy can lead to recurrent inflammation in the appendiceal stump. We describe a 28-year-old man with stump appendicitis due to a retained fecalith postappendectomy. Our approach, akin to interval appendectomy, combines antibiotics and endoscopic intervention postinfection resolution. This case highlights the feasibility and safety of endoscopic management, offering a nonsurgical alternative to prevent the morbidity associated with revision surgery. Further exploration of nonsurgical modalities is warranted to optimize patient outcomes.

Keywords: appendicolith; endoscopy; fecalith; medical management; stump appendicitis.

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Figures

Figure 1.
Figure 1.
(A) Endoscopic view of SpyGlass catheter at the appendiceal orifice; (B) Fecalith within the appendiceal remnant visualized with SpyGlass camera; (C) SpyGlass camera view of stone fragments broken down by lithotripter probe (arrow) introduced through SpyGlass catheter; (D) Endoscopic view of stone fragments within the cecum.
See this image and copyright information in PMC

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