Scientific paperCrohn’s disease limited to the appendix
Section snippets
Material and methods
Here we review the clinical records of all patients diagnosed of Crohn’s disease of the appendix at La Paz University Hospital, Madrid, Spain, between January 1, 1975, and January 1, 1995, excluding patients with simultaneous intestinal and appendiceal symptoms. Patient with positive cultures for Yersinia SP were excluded from the study. These cultures were carried out for all patients. However, serologic tests were not performed because this procedure was not available at our medical center
Results
Ten (0.2%) patients were diagnosed of CD confined to the appendix (6 male and 4 female patients, with an average age of 29 years [range 10 to 33]). The duration of symptoms varied from 1 day to 4 months. All 10 patients complained of pain in the right iliac fossa, 7 patients had nausea and vomiting, 3 were anorexic, and 3 had fever. One patient reported diarrhea 10 days before surgery suggestive of rectal bleeding, although 1 patient had had episodes of diarrhea before hospitalization. Two
Comments
Chronic transmural inflammation with epithelioid granuloma formation in the intestinal wall is characteristic of CD, a condition that can affect the entire length of the gastrointestinal tract [4], [5], [6]. CD confined to the appendix has been reported to occur in 12% to 16% of CD patients undergoing intestinal resection [7] and in 50% of patients with colonic CD [8]. Of the 4,468 appendectomies performed during the period of our study (ie, 20 years), only 0.2% of patients had CD confined to
References (15)
- et al.
Crohn’s disease isolated to the appendixtruths and fallacies
Hum Pathol
(1986) - et al.
Etiology of small bowel obstruction
Am J Surg
(2000) - et al.
Idiopathic granulomatous appendicitis or Crohn’s disease of the appendix revisited
Hum Pathol
(1993) - et al.
Isolated Crohn’s disease of the appendix. Two case reports and a review of the literature
Arch Surg
(1988) - et al.
Crohn’s disease of the appendix
Eur J Surg
(1993) - et al.
Apendicitis granulomatosa y enfermedad de Crohn apendicularanalisis de nuestra experiencia y revisión de la bibliografia
Cir Esp
(1998) - et al.
Granulomas of the appendixis it Crohn’s disease?
Scand J Gastroenterol
(1991)
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2018, Journal of Pediatric Surgery Case ReportsCitation Excerpt :This suggests a secondary reactive appendicitis by virtue of its proximity to the inflamed cecal epiploic appendage. Reactive inflammation of the appendix has been described with other entities including Meckel's diverticulitis [16,17] and inflammatory bowel disease [18,19], however, to our knowledge, this is the only reported case of primary cecal epiploic appendagitis causing reactive appendicitis. Primary cecal epiploic appendagitis is in the differential diagnosis of a child with acute right lower quadrant pain.
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2017, International Journal of Surgery Case ReportsCitation Excerpt :Between 0.2 and 2.5% of appendectomy patients have been found to have Crohn’s disease across multiple series [4,5,17]. Twelve to 16% of patients with Crohn’s disease who have ileal involvement and 20–50% with colonic involvement present with the inflammatory process extending to the appendix [18–20]. About 85% of patients with appendiceal Crohn’s present with acute abdominal pain in the right iliac fossa, similar to classic appendicitis symptoms [5,16].
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2014, Annales de PathologieGranulomatous appendicitis in a 12-year-old boy
2010, Journal of Pediatric SurgeryCitation Excerpt :Infectious and noninfectious causes have been responsible for 62% and 38% of GA, respectively. Pathogenic Yersinia species were demonstrated in approximately 25% to 38% of GA cases [16,19]. Granulomas with central necrosis, typical of a Yersinia infection, were seen in our patient; but result of serology for Yersinia was negative.
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