World journal of pediatric surgery · 2026
Endoscopic retrograde appendiceal irrigation for children with recurrent abdominal pain and appendiceal fecaliths: a retrospective cohort study.
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Wang Fengge, Zhu Zhenni, Hu Chijun, Liu Qin
Аннотация
BACKGROUND: Recurrent abdominal pain (RAP) in children with appendiceal fecaliths and mesenteric lymphadenitis poses a diagnostic and therapeutic challenge, often mimicking appendicitis. The role of interventional endoscopy in this setting is undefined.
METHODS: We retrospectively analyzed children with RAP, sonographically confirmed appendiceal fecaliths, and ileocecal lymphadenitis who underwent ultrasound-guided endoscopic retrograde appendiceal irrigation (ERAI) from 2021 to 2023. Technical success, complications, immediate symptom resolution, and follow-up outcomes were assessed.
RESULTS: Totally, 73 patients (mean age 8.3 years) who underwent successful ERAI (100% technical success) were included in this study for safety analysis. Three were lost to follow-up, leaving 70 for efficacy analysis. Immediate pain resolution was reported in 98.6% (69/70) of patients with follow-up. Minor complications such as self-limiting bleeding and procedure-related discomfort occurred in 8.2% (6/73) and 9.6% (7/73) of patients, respectively. There were no perforations or major adverse events. During a median follow-up of 15.5 months, the abdominal pain recurrence rate was 18.6%. The sonographic prevalence of mesenteric lymphadenitis decreased significantly from 100% preoperatively to 21.9% postoperatively (p<0.01).
CONCLUSIONS: ERAI appears to be a feasible and safe super-minimally invasive procedure for selected children with RAP associated with appendiceal fecaliths and lymphadenitis, and was associated with rapid symptomatic relief and a significant reduction in lymphadenitis.
METHODS: We retrospectively analyzed children with RAP, sonographically confirmed appendiceal fecaliths, and ileocecal lymphadenitis who underwent ultrasound-guided endoscopic retrograde appendiceal irrigation (ERAI) from 2021 to 2023. Technical success, complications, immediate symptom resolution, and follow-up outcomes were assessed.
RESULTS: Totally, 73 patients (mean age 8.3 years) who underwent successful ERAI (100% technical success) were included in this study for safety analysis. Three were lost to follow-up, leaving 70 for efficacy analysis. Immediate pain resolution was reported in 98.6% (69/70) of patients with follow-up. Minor complications such as self-limiting bleeding and procedure-related discomfort occurred in 8.2% (6/73) and 9.6% (7/73) of patients, respectively. There were no perforations or major adverse events. During a median follow-up of 15.5 months, the abdominal pain recurrence rate was 18.6%. The sonographic prevalence of mesenteric lymphadenitis decreased significantly from 100% preoperatively to 21.9% postoperatively (p<0.01).
CONCLUSIONS: ERAI appears to be a feasible and safe super-minimally invasive procedure for selected children with RAP associated with appendiceal fecaliths and lymphadenitis, and was associated with rapid symptomatic relief and a significant reduction in lymphadenitis.