Doença de Crohn isolada do apêndice cecal como causa de enterorragia

Lima, Sizenando Ernesto de; Speranzini, Manlio Basílio; Guiro, Marcos Pacheco

doi:10.1590/s0004-28032004000100012

Cited by 6 publications

(1 citation statement)

References 5 publications

(8 reference statements)

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“…The etiology of appendiceal bleeding have been reported to include appendicitis, diverticulum, angiodysplasia, inflammation bowel disease, endometriosis, tumor, tuberculosis and dieulafoy's disease, in which appendicitis is the most common one [1,[5][6][7][8][9][10]. Some of appendiceal bleeding cases is acute, but most of the them is chronic and insidious [5].…”

Section: Discussionmentioning

confidence: 99%

Clinical features, treatments and prognosis of appendiceal bleeding: a case series study

Xing,

Yang,

Xiao

2023

BMC Gastroenterol

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Background Appendiceal bleeding is a rare cause of lower gastrointestinal bleeding, could be overlooked and diagnosed as obscure gastrointestinal bleeding. Due to limited real-world cases, the optimized management of appendiceal bleeding is unclear. We here shared our experiences in the past 20 years. Methods A retrospective study was conducted at West China Hospital of Sichuan University. We reviewed data of 28,175 colonoscopies from 43,095 gastrointestinal bleeding patients between June 2003 and June 2023. Six patients diagnosed as appendiceal bleeding were included. Data including symptoms, laboratory tests, imaging results, endoscopic findings, treatment and prognosis were collected and analyzed. Results Appendiceal bleeding accounts for 0.014% in gastrointestinal bleeding patients. Of the six patients, five were male, with a mean age of 48.5 years. Hematochezia was the most common symptom. The etiology included appendiceal angiodysplasia, appendicitis and appendectomy associated bleeding. Hemostasis was achieved by appendectomy, endoscopic therapy or medication according to different cases. One patient did not receive any treatment because of self-limiting bleeding. Conclusions The diagnosis of appendiceal bleeding is challenging, repeated flushing during endoscopy is helpful. Appendectomy is the priority option for treatment as well as the etiology clarification, therapeutic endoscopy and medication could be considered case by case.

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Section: Discussionmentioning

confidence: 99%

Clinical features, treatments and prognosis of appendiceal bleeding: a case series study

Xing,

Yang,

Xiao

2023

BMC Gastroenterol

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Crohn’s disease limited to the appendix: a case report in a pediatric patient

et al. 2010

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In the original description of Crohn's disease, the appendix was not believed to be involved in the inflammatory process. Later on, case reports started to appear in publications demonstrating that the appendix could be involved in the inflammatory changes of Crohn's disease, and it could also be the primary or the sole manifestation of the disease. Being that appendectomies are one of the most common procedures performed by pediatric surgeons, the knowledge about this diagnosis, all be it rare, is important. Our aim was to report a case and discuss the results of our literature review in order to elucidate the probability of a pediatric patient subsequently developing full Crohn's disease and the follow up that is indicated in such patients. A 12-year-old male patient presented with a history of chronic abdominal pain (3-4 times per week) for 1 year, crampy in nature, localized in the left lower quadrant, and associated with diarrhea (2 episodes per day). There were no extraintestinal manifestations of Crohn's, such as arthralgia or uveitis. Important family history included two paternal uncles with ulcerative colitis both of whom currently have stomas. The only abnormal laboratory value in our patient was an elevated fecal calprotectin level. An esophagogastroduodenoscopy and colonoscopy were performed and found to be unremarkable except for the cecum where it appeared that an exudate was emanating from the appendiceal orifice. A magnetic resonance enterography was ordered and showed an enlarged enhancing appendix. An exploratory laparoscopy identified an appendix with macroscopic cobblestone or lymphoid reaction that histologically was consistent with Crohn's disease. It appears that the Crohn's appendix is more indolent than Crohn's disease of the ileum or colon, with a recurrence rate in the largest series of 8%. The interval time from diagnosis to recurrence varied from 1 to 48 months with an average of 19 months. Some authors debate the need of follow up at all in those patients, believing that the appendectomy alone is curative in the majority of patients. Others recommend follow up for up to 5 years.

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Appendiceal Crohn’s disease: a rare differential of right iliac fossa pain

et al. 2020

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A 30-year-old man with a history of severe right iliac fossa pain was referred to the surgical emergency unit. His symptoms began 3 days prior as mild, non-specific abdominal pain which progressively localised to the right iliac fossa and worsened in severity. Investigations were suggestive of acute appendicitis, and therefore a laparoscopic appendicectomy was planned. Laparoscopy revealed a thickened, necrotic appendix with a mass at the base of the appendix, in keeping with the appearance of an appendiceal malignancy. Subsequently a right hemicolectomy was performed. Histology revealed active chronic inflammation and granulomas highly suggestive of appendiceal Crohn’s disease. Since, the patient has made a good recovery and presently shows no further signs of Crohn’s disease. This case is demonstrative of one of many rare findings on histological examination of the appendix. It emphasises the need for a wide differential when investigating right iliac fossa pain.

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Doença de Crohn isolada do apêndice cecal como causa de enterorragia

Abstract: This case, like others in the literature, appendectomy is curative, but a 5-year follow-up is mandatory. When a young patient presents with enterorrhagia, this diagnosis has to be considered.

Cited by 6 publications

References 5 publications

Clinical features, treatments and prognosis of appendiceal bleeding: a case series study

Clinical features, treatments and prognosis of appendiceal bleeding: a case series study

Crohn’s disease limited to the appendix: a case report in a pediatric patient

Appendiceal Crohn’s disease: a rare differential of right iliac fossa pain

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