ReviewIntussusception of the appendix: comprehensive review of the literature
Section snippets
Methods
The medical records of a 40-year-old woman with history of endometriosis who presented with RLQ pain and was found to have intussusception of the appendix were reviewed and presented in the case report.
A PubMed search using the following key word combinations was performed: “appendix and intussusception,” “appendiceal and intussusception,” “intussuscepted and appendix,” and “appendiceal and intussuscepted.” The search resulted in 346 articles, which were reviewed individually. Only 147 papers
Case report
A 40-year-old woman presented to the emergency department with a history of 4 days of intermittent abdominal pain. The pain was progressively worsening. She complained of nausea and chills but no vomiting or diarrhea. The physical examination was notable for RLQ pain more than left with guarding. She was afebrile and had a borderline white blood cell count of 10.7.
Her past medical history was notable for uterine fibroids and endometriosis. She had a remote history of a uterine myomectomy for a
Results
Intussusception of the appendix is more common in adults (76%) than in children (24%). Female patients (72%) are >2 times more affected than men (28%) in the adult population, whereas male patients (58%) may be slightly more affected in the pediatric population (Table 2). Patient age varies from 5 months to 85 years, and the average age of presentation is 7 years in pediatric patients and 46 years in adult patients.
Intussusception can be reversed, especially if it is not associated with a lead
Comments
McKidd first reported intussusception of the appendix in 1858.23 Since the first report, the literature on appendiceal intussusception has been limited to case reports and small case series. Forshall24 and Bachman and Clement25 wrote the largest case series, presenting 7 patients each. The incidence, demographics, and characteristics of appendiceal intussusception are almost impossible to determine because of the rarity of the condition. Some investigators attempted limited reviews of the
References (43)
- et al.
Appendiceal intussusception caused by a mucocele of the appendix: imaging findings
Digest Liver Dis
(2007) - et al.
Appendicular mucosal intussusception into the cecum secondary to an intramural mucinous cystoadenoma of the appendix
J Am Coll Surg
(2007) - et al.
Mucosa-associated lymphoid tissue lymphoma in the appendix, a lead point for intussusception
J Pediatr Surg
(2005) - et al.
Appendiceal intussusception
J Am Coll Surg
(2001) - et al.
Endoscopic appendectomy
Gastrointest Endosc
(1976) - et al.
The epidemiology of appendicitis and appendectomy in the United States
Am J Epidemiol
(1990 Nov) 71,000 human appendix specimensA final report, summarizing forty years' study
Am J Proctol
(1963)- et al.
Coiled-spring sign of appendiceal intussusception
Radiology
(1985) - et al.
Intussusception of the appendix
Dis Colon Rectum
(1984) - et al.
Intussusception of the appendixCase reports and reviews of the literature
Am J Gastroenterol
(1964)