Isolated Crohn’s disease of the vermiform appendix or chronic granulomatous appendicis?

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2007 (EN)
Isolated Crohn’s disease of the vermiform appendix or chronic granulomatous appendicis? (EN)

Mpaltayiannis G.,
Christodoulou D.,
Tsianos E.,
Katsanos K.,

SUMMARY The etiology of granulomatous appendicitis includes infectious diseases, foreign bodies and diseases of unknown etiology such as Crohn’s disease and sarcoidosis. Pain in the right lower guardant is a common symptom of intestinal Crohn’s disease but, pain in this area can also be the presenting symptom of acute appendicitis. Crohn’s disease affects any part of the gastrointestinal tract including the vermiform appendix. Crohn’s disease initially confined to the appendix is rare and there are less than 100 well-documented cases in the literature. A 28-years-old female patient was admitted to our hospital because of fever up to 39oC and abdominal pain in the right lower quadrant with bloating. Serology and faecal, urine and blood cultures for microbial infection including Yersinia proved negaive. Lower abdomen ultrasonography revealed no evidence of adnexae inflammation but suspected thickness of the bowel wall in the right lower quadrant. Because of no response to conservative treatment two months later surgery was performed. At laparotomy a long, thickened and distended appendix was found and removed. No other lesions were noted in the intestines or mesentery. Histological examination of the removed appendix showed signs compatible with Crohn’s disease of the appendix. In case of Crohn’s disease of the appendix two clinical possibilities may arise; the first is the presence of mild Crohn’s disease in other intestinal parts and the second possibility is the risk of relapse which occurred in 7-14% of the published cases. Could this case be regarded as an isolated Crohn’s disease of the appendix or as a granulomatous and follicular appendicitis of unknown etiology (idiopathic) and unrelated to a “formal ” Crohn’s disease according to the accepted definition. Key words: Crohn’s disease, appendix, granuloma, appendicitis (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 14, No 2 (2001) (EN)

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