A Case of Perforation of the Appendix Caused by aberrantly positioned Clips Used for Endoscopic Therapy

Abstract

The patient was an 81-year-old male who had undergone endoscopic resection of a polyp in the ascending colon in August 2010. At the end of April 2012, he visited our hospital with the complaint of localized, progressively worsening right lower abdominal pain, and was diagnosed as having appendicitis and hospitalized. An X-ray examination revealed two clips used for the endoscopic therapy overlapping in a V formation in the right lower abdomen, and CT showed the clips at the tip of the appendix. Emergency laparotomy was performed. The appendix was found to be thickened and surrounded by an abscess; therefore, appendectomy and drainage were performed. Two clips arranged in a V formation were found to be stuck in the appendix, perforating it. It is rare for endoscopic clips to cause harm; however, as in this case, multiple clips can together cause perforation.