Appendectomy and Crohn's Disease

Abstract

Introduction Crohn's Disease is a chronic and idiopathic inflammatory process with transmural invasion that can affect the entire gastrointestinal tract. The etiopathogenesis of this pathology is not fully understood and studies have been carried out to understand the influence of different kind of factors on its development, including appendectomy. This monograph aims to address the possible existence of a link between appendectomy and Crohn's Disease, and the possible causes and clinical consequences of this association. Methods This monograph was based on the research of original scientific articles in MEDLINE database via PubMed, restricted to articles in Portuguese and English during the period between 1991 and 2017. Results Appendectomy seems positively associated with the development of Crohn's Disease, especially in the first years of surgery, regardless of whether or not there is inflammation of the appendix. In fact, the appendix plays important roles in gastrointestinal integrity, acting in the development of an adequate immune response, maintaining and regulating the intestinal flora. Conclusion The appendix is important for intestinal homeostasis, preventing the development of certain pathologies. Its resection, regardless of whether or not there is an inflammation after surgery, increases the risk of Crohn's Disease and worsens the prognosis of this pathology, so appendectomy should be avoided in the absence of appendicitis.

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

“…We also found 0.3% cases of meningitis and 01% of appendicitis in the under 20 age group with a significant rate. These results have been proven by 6,21 . Other IPs were found in our study, namely ulcers that appear in the under-20 age group and inflammatory anemia that occurs at <20-40 years of age.…”

“…Certain risk factors such as tobacco, infection, pharmacological agents, stress, pollution and diet have been the most incriminated causes of these pathologies 5 . However, some studies in the development of CD are contradictory, as some have found that appendectomy has a role in the onset and clinical course of the disease, while others have shown that there is no association between appendectomy and the development of CD 6 .…”

“…In our study 22.4% of patients were smokers (also noticed by Bandyopadhyay et al, 2015); 6.1% of men were alcoholic and 17.3% of patients had an appendictomy. Ameta-analysis of several studies has shown that, despite the heterogeneity, there is still a higher relative risk of developing crohn's disease after appendectomy 6,23 .…”

Epidemiological Study and Clinical Characteristics of Crohn's Disease in The West Algerian Population

“…Based on risk factors, we found that17% of our patients had undergone an appendectomy; (Feuerstein and Cheifetz, 2017;Kaplan et al,2008;Loureiro and Barbosa, 2019). It has been found that after an appendectomy, there is a risk of developing Crohn's disease.…”