Gong Pan, Wu Xujia, Xiang Rengyun, Yu Yang, Peng Xia, Li Xuefeng
Department of Gastroenterology, The First Affiliated Hospital of Jishou University, Jishou, 416000, Hunan, China.
Jishou University School of Medicine, Jishou, China.
Int J Colorectal Dis. 2025 Apr 8;40(1):89. doi: 10.1007/s00384-025-04884-z.
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.
Here, we report a rare case of a UC with AOI.
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.
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.
溃疡性结肠炎（UC）是一种主要累及结直肠黏膜的慢性非特异性炎症性肠病。该病具有复发-缓解病程的特点，目前无法治愈。其发病机制是多因素的，涉及遗传易感性、环境触发因素、免疫失调以及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作用。伴有阑尾开口炎症（AOI）或阑尾周围红斑（PARP）的左侧结肠炎是UC中常见的内镜表现。然而，UC患者的AOI是否需要干预仍存在争议。
在此，我们报告一例罕见的伴有AOI的UC病例。
通过胆道镜辅助内镜逆行阑尾炎治疗（ERAT），发现阑尾腔内有大量脓性分泌物并冲洗出来，导致UC临床缓解和内镜下黏膜愈合。
我们的病例表明阑尾与溃疡性结肠炎的发病机制之间可能存在某种关联。对于伴有AOI的难治性左侧UC患者，基于ERAT的阑尾腔炎症管理可能使患者受益。
