Cholangioscope-assisted ERAT for the diagnoses and treatment of ulcerative colitis with appendiceal orifice inflammation: a case report and a literature review.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-04-08 DOI:10.1007/s00384-025-04884-z

Pan Gong, Xujia Wu, Rengyun Xiang, Yang Yu, Xia Peng, Xuefeng Li

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引用次数: 0

Abstract

Purpose: Ulcerative colitis (UC) is a chronic, nonspecific inflammatory bowel disease primarily affecting the colorectal mucosa. The disease is characterized by a relapsing-remitting course and is currently incurable. Its pathogenesis is multifactorial, involving genetic predisposition, environmental triggers, immune dysregulation, and alterations in gut microbiota. The appendix plays a role in modulating intestinal immunity and maintaining microbial homeostasis. Left-sided colitis with appendiceal orifice inflammation (AOI) or periappendiceal erythematous patch (PARP) is a common endoscopic finding in UC. However, whether AOI in UC patients requires intervention remains debated.

Methods: Here, we report a rare case of a UC with AOI.

Results: By means of cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT), copious purulent secretions were discovered and flushed out of the appendiceal cavity, resulting in clinical remission and endoscopic mucosal healing of UC.

Conclusion: Our case indicates that there may be some correlation between the appendix and the pathogenesis of ulcerative colitis. For refractory left-sided UC patients with AOI, ERAT-based management of appendiceal lumen inflammation may benefit patients.

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胆道镜辅助ERAT诊断治疗溃疡性结肠炎伴阑尾口炎1例并文献复习。

目的：溃疡性结肠炎（UC）是一种慢性、非特异性炎症性肠病，主要影响结肠黏膜。该疾病的特点是复发缓解过程，目前无法治愈。其发病机制是多因素的，涉及遗传易感性、环境触发、免疫失调和肠道微生物群的改变。阑尾在调节肠道免疫和维持微生物稳态方面发挥着重要作用。左侧结肠炎伴阑尾口炎（AOI）或阑尾周围红斑斑（PARP）是UC常见的内镜发现。然而，UC患者AOI是否需要干预仍有争议。方法：在此，我们报告一例罕见的UC合并AOI。结果：经胆管镜辅助内镜下逆行性阑尾炎治疗（ERAT），发现大量化脓性分泌物从阑尾腔排出，UC临床缓解，内镜下粘膜愈合。结论：本病例提示阑尾与溃疡性结肠炎的发病机制可能存在一定的相关性。对于伴有AOI的难治性左侧UC患者，基于erat的阑尾管腔炎症治疗可能对患者有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.