Abstract
Endoscopic appendicitis therapy (EAT) is an emerging minimally invasive alternative to surgery. This case highlights using endoscopic ultrasound (EUS) to facilitate cholangioscope-guided appendicoscopy. A 41-year-old woman presented with acute right lower quadrant pain and leukocytosis. Computed tomography confirmed acute appendicitis. The patient opted for EAT. EUS identified appendiceal orientation, enabling smooth cholangioscope intubation via colonoscope. Irrigation cleared purulent discharge. Following rapid recovery, the patient remained asymptomatic at 3-month follow-up. EUS-assisted EAT improves access, precision, and efficiency in endoscopic management of appendicitis. This technique may broaden the role of minimally invasive, organ-preserving approaches as an alternative to surgery in selected patients.