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Colonoscopy is a common diagnostic procedure for colon. Colonic perforation is a well-known iatrogenic complication of diagnostic colonoscopy. However, appendiceal involvement with inflammation or perforation is extremely rare and only a few cases of post-colonoscopy appendicitis have been reported so far. We describe a series of four cases operated in our clinic for acute appendicitis that developed in young age, shortly after colonoscopic examination for another pathology (irritable bowel syndrome, diverticular colonic disease, left iliac fossa and left flank pain).