Abstract
Introduction and importanceAcute lower gastrointestinal bleeding (LGIB) is common in clinical practice, however, appendiceal bleeding is extremely rare, which easy to be missed and misdiagnosed. Case presentationWe presented a case of a 33-year-old female who complained of hematochezia that had lasted for 1 day, colonoscopy showed continuous bleeding in the appendiceal orifice. A laparoscopic appendectomy was performed immediately, a pulsating blood vessel can be seen in the mesangium of the appendix, accordingly, active bleeding into the appendicular lumen was considered. Appendiceal pathology showed a large number of hyperplastic vessels were seen in the appendix mucosa and capillary vessels were dilated. Clinical conclusionAppendiceal bleeding is rare, lack of related guidelines and consensus, the preoperative detection of appendiceal bleeding is often challenging. Colonoscopy is extremely important, bowel preparation is not recommended for patients with acute LGIB routinely or only low-dose bowel preparation is recommended. Laparoscopic appendectomy is the most appropriate treatment for appendiceal bleeding. DiscussionIn our case, we provided the relevant data of computed tomography (CT), colonoscopy, pathology and laparoscopic surgery, and analysed the appendiceal bleeding caused by vascular malformation, to provide clinical experience.
Published Version
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