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      Apendicitis poscolonoscopia: reporte de caso y revisión de la literatura Translated title: Post-colonoscopy appendicitis: Case report and literature review

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          Abstract

          Resumen Presentamos el caso de una paciente de 83 años sin antecedentes de importancia, a quien se le realizó una colonoscopia de tamización 3 h antes del inicio de la sintomatología. La paciente consultó al servicio de urgencias por presentar dolor en la fosa ilíaca derecha de 12 h de evolución. En efecto, durante el examen físico, se encontró un dolor localizado en la fosa ilíaca derecha. Ante la sospecha de una complicación relacionada con la colonoscopia, se ordenó una tomografía de abdomen, la cual mostró signos tomográficos de apendicitis. Se realizó entonces una apendicetomía por laparoscopia, sin complicaciones, pero se evidenció un apéndice cecal perforado.

          Translated abstract

          Abstract We present the case of an 83-year-old patient who had no significant medical history. A screening colonoscopy had been performed three 3 hours before onset of pain in the right iliac fossa. Twelve hours later, the patient to the emergency department. Physicians suspected that the pain was a complication related to colonoscopy and ordered an abdominal CT scan which showed tomographic signs of appendicitis. A laparoscopic appendectomy was performed and removed a perforated cecal appendix without complications.

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          Complications of colonoscopy.

          Colonoscopy is a relatively invasive modality for the diagnosis and treatment of colorectal disease and for the prevention or early detection of colorectal neoplasia. Millions of colonoscopies are performed each year in the United States by endoscopists with varying levels of skill in colons that present varying levels of challenge. Although better scope technology has made colonoscopy gentler and more accurate, the sheer number of examinations performed means that complications inevitably occur. This article considers the most common complications of colonoscopy, and advises how to minimize their incidence and how to treat them if they do occur.
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            Acute Appendicitis Caused by Colonoscopy

            A 48-year-old woman who was without any abnormal past medical history underwent colonoscopy as a screening procedure for colorectal disease. The procedure was uneventful and there was no sign of inflammation around the appendicular orifice or the luminal surface of the cecum. The patient did not complain of pain or significant discomfort throughout the procedure. She then developed pain in the right lower quadrant of the abdomen that evening and this persisted for four days. She visited the outpatient department and underwent abdominal ultrasonography, which showed a swollen appendix with a collection of pericecal fluid. Surgical exploration and appendectomy were performed; the final diagnosis was acute suppurative appendicitis. Colonoscopists should be aware of this rare complication and consider it when making the differential diagnosis of post-colonoscopy abdominal pain.
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              Post-colonoscopy appendicitis: A case report and systematic review.

              Colonoscopy is a widely used diagnostic and therapeutic modality with a relatively low morbidity. However, given the large volume of procedures performed, awareness of the infrequent complications is essential. Perforation is an established complication of colonoscopy, and can range from 0.2%-3% depending on the series, population and modality of colonoscopy. Acute appendicitis after colonoscopy is an extremely rare event, and a cause-effect relationship between the colonoscopy and the appendicitis is not well documented. In addition, awareness of this condition can aid in prompt diagnosis. Relatively mild symptoms and exclusion of bowel perforation by contrast studies do not exclude appendicitis from the differential diagnosis for post-colonoscopy pain. In addition to the difficult diagnosis inherent to postcolonoscopy appendicitis, treatment strategies have varied greatly. This paper reviews these approaches. We also expand upon prior articles by giving guidance for the role of nonoperative management in these patients. This case and review of the literature will help to create awareness about this complication, and guide optimal treatment of pericolonoscopy appendicitis.
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                Author and article information

                Journal
                rcg
                Revista Colombiana de Gastroenterologia
                Rev Col Gastroenterol
                Asociación Colombiana de Gastroenterología (Bogotá, , Colombia )
                0120-9957
                March 2020
                : 35
                : 1
                : 127-129
                Affiliations
                [2] Bogotá Bogotá orgnameUniversidad del Rosario Colombia
                [3] Bogotá orgnameHospital Universitario Barrios Unidos Colombia
                [4] Bogotá Arauca orgnameUniversidad Nacional de Colombia Colombia
                [1] Bogotá Bogotá orgnameUniversidad del Rosario Colombia
                Article
                S0120-99572020000100127 S0120-9957(20)03500100127
                10.22516/25007440.324
                9facbae4-6f15-4d9a-ae62-83e91d4b408e

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 20 January 2019
                : 03 December 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 3
                Product

                SciELO Colombia

                Categories
                Reporte de casos

                complication,Colonoscopia,Colonoscopy,complicación,apendicitis

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