{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:12:01Z","timestamp":1780920721346,"version":"3.54.1"},"reference-count":13,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["World Jnl Ped Surgery"],"accepted":{"date-parts":[[2026,5,11]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"\n Background<\/jats:title>\n Recurrent abdominal pain (RAP) in children with appendiceal fecaliths and mesenteric lymphadenitis poses a diagnostic and therapeutic challenge, often mimicking appendicitis. The role of interventional endoscopy in this setting is undefined.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed children with RAP, sonographically confirmed appendiceal fecaliths, and ileocecal lymphadenitis who underwent ultrasound-guided endoscopic retrograde appendiceal irrigation (ERAI) from 2021 to 2023. Technical success, complications, immediate symptom resolution, and follow-up outcomes were assessed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Totally, 73 patients (mean age 8.3 years) who underwent successful ERAI (100% technical success) were included in this study for safety analysis. Three were lost to follow-up, leaving 70 for efficacy analysis. Immediate pain resolution was reported in 98.6% (69\/70) of patients with follow-up. Minor complications such as self-limiting bleeding and procedure-related discomfort occurred in 8.2% (6\/73) and 9.6% (7\/73) of patients, respectively. There were no perforations or major adverse events. During a median follow-up of 15.5 months, the abdominal pain recurrence rate was 18.6%. The sonographic prevalence of mesenteric lymphadenitis decreased significantly from 100% preoperatively to 21.9% postoperatively (\n p<\/jats:italic>\n <0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n ERAI appears to be a feasible and safe super-minimally invasive procedure for selected children with RAP associated with appendiceal fecaliths and lymphadenitis, and was associated with rapid symptomatic relief and a significant reduction in lymphadenitis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/wjps-2025-001152","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:50:21Z","timestamp":1780919421000},"page":"e001152","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic retrograde appendiceal irrigation for children with recurrent abdominal pain and appendiceal fecaliths: a retrospective cohort study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6870-8775","authenticated-orcid":false,"given":"Fengge","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9431-6617","authenticated-orcid":false,"given":"Zhenni","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4969-3779","authenticated-orcid":false,"given":"Chijun","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6682-4237","authenticated-orcid":false,"given":"Qin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2026060804501829000_9.3.e001152.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0126982","article-title":"Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis","volume":"10","author":"Korterink","year":"2015","journal-title":"PLoS One"},{"key":"2026060804501829000_9.3.e001152.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-012-2358-6"},{"key":"2026060804501829000_9.3.e001152.3","doi-asserted-by":"crossref","first-page":"W543","DOI":"10.2214\/AJR.13.12093","article-title":"Value of gadolinium-enhanced MRI in detection of acute appendicitis in children and adolescents","volume":"203","author":"Rosines","year":"2014","journal-title":"AJR Am J 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appendicitis","volume":"54","author":"Yang","year":"2022","journal-title":"Endoscopy"},{"key":"2026060804501829000_9.3.e001152.9","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10100984"},{"key":"2026060804501829000_9.3.e001152.10","doi-asserted-by":"crossref","first-page":"313","DOI":"10.5114\/aoms.2018.79430","article-title":"Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization","volume":"16","author":"\u00d6zdamar","year":"2018","journal-title":"Arch Med Sci"},{"key":"2026060804501829000_9.3.e001152.11","first-page":"360","article-title":"Application of ultrasound-guided endoscopic retrograde appendicitis therapy in children with appendix-related chronic abdominal pain","volume":"24","author":"Kang","year":"2022","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"2026060804501829000_9.3.e001152.12","doi-asserted-by":"crossref","first-page":"853","DOI":"10.2214\/ajr.178.4.1780853","article-title":"Mesenteric adenitis: CT diagnosis of primary versus secondary causes, incidence, and clinical significance in pediatric and adult patients","volume":"178","author":"Macari","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"2026060804501829000_9.3.e001152.13","doi-asserted-by":"crossref","first-page":"6291","DOI":"10.1007\/s00464-020-08129-8","article-title":"The modified endoscopic retrograde appendicitis therapy versus antibiotic therapy alone for acute uncomplicated appendicitis in children","volume":"35","author":"Kang","year":"2021","journal-title":"Surg Endosc"}],"container-title":["World Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/wjps-2025-001152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:50:23Z","timestamp":1780919423000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjps.bmj.com\/lookup\/doi\/10.1136\/wjps-2025-001152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,8]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/wjps-2025-001152"],"URL":"https:\/\/doi.org\/10.1136\/wjps-2025-001152","relation":{},"ISSN":["2516-5410"],"issn-type":[{"value":"2516-5410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}