Endoscopic transcecal appendectomy for recurrent appendicitis after previous endoscopic mucosal resection

A 47-year-old man suffered from acute appendicitis 4 years ago, relieved by a 3-day course of oral levofloxacin. A follow-up colonoscopy 1 year later revealed a 1.5-cm submucosal bulge near the appendiceal orifice. The patient underwent endoscopic mucosal resection (EMR) for the lesion at that hospital ([Fig. 1]) and was referred to our hospital for routine follow-up owing to the possibility of recurrence. Colonoscopy again found a submucosal bulge near the appendiceal orifice with purulent exudates ([Fig. 2]).