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

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.