Diagnostic and therapeutic value of endoscopic retrograde appendicitis therapy for atypical acute appendicitis

Objective To investigate the value of endoscopic retrograde appendicitis therapy (ERAT) in the diagnosis and treatment of atypical acute appendicitis. Methods All the 48 patients suspected of atypical acute appendicitis in Jiangsu Province Hospital from January 2015 to December 2016 were randomly divided into ERAT group and conservative treatment group according to the treatment method. The final appendectomy rate of the two groups was analyzed. Results Only 17 of the 24 patients in the ERAT group received endoscopic treatment because of complex conditions or personal wishes, and 16 cases were diagnosed as acute appendicitis. Surgical resection was performed in 5 cases because of recurrence of the disease after ERAT, and the appendectomy rate was 31.2% (5/16). In the conservative treatment group, all 24 patients were treated with antibiotics. Twenty of them underwent surgical resection with appendectomy rate of 83.3% (20/24), and 1 of them had appendiceal perforation. The appendectomy rate of the ERAT group was significantly lower than that of the conservative treatment group (χ2=11.111, P<0.05). Conclusion ERAT has a high diagnostic and therapeutic value for atypical acute appendicitis. Key words: Appendicitis, atypical; Diagnosis; Therapy; Endoscopic retrograde appendicitis therapy