Crohn’s disease limited to the appendix

Prieto-Nieto, Isabel; Perez-Robledo, Juan P; Hardisson, David; Rodríguez-Montes, José Antonio; Larrauri-Martinez, Javier; Garcia-Sancho-Martin, Luis

doi:10.1016/s0002-9610(01)00811-x

Cited by 43 publications

(35 citation statements)

References 8 publications

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“…First, appendicitis may be the first manifestation of Crohn's disease. The appendix is frequently involved by Crohn's disease [17] , granulomatous appendicitis may in some cases reveal Crohn's disease [18,19] , and resection of a Crohn' s disease appendix may be followed by a long period of remission [20,21] . However, most pathological studies concluded that idiopathic granulomatous appendicitis is nosologically distinct from Crohn's disease [22] and that most of these patients do not develop subsequent Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

Prior appendectomy and the phenotype and course of Crohn’s disease

Cosnes

Seksik²,

Nion–Larmurier³

et al. 2006

WJG

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AIM:To determine whether prior appendectomy modifies the phenotype and severity of Crohn's disease. METHODS:Appendectomy status and smoking habits were specified by direct interview in 2838 patients consecutively seen between 1995 and 2004. Occurrence of complications and therapeutic needs were reviewed retrospectively. Additionally, annual disease activity was assessed prospectively between 1995 and 2004 in patients who had not had ileocecal resection and of a matched control group. RESULTS:Compared to 1770 non-appendectomized patients, appendectomized patients more than 5 years before Crohn's disease diagnosis (n =716) were more often females, smokers, with ileal disease. Cox regression showed that prior appendectomy was positively related to the risk of intestinal stricture (adjusted hazard ratio, 1.24; 95% confidence interval, 1.13 to 1.36; P = 0.02) and inversely related to the risk of perianal fistulization (adjusted hazard ratio, 0.75; 95% confidence interval, 0.68 to 0.83; P = 0.002). No difference was observed between the two groups regarding the therapeutic needs, except for an increased risk of surgery in appendectomized patients, attributable to the increased prevalence of ileal disease. Between 1995 and 2004, Crohn's disease was active during 50% of years in appendectomized patients (1 318 out of 2 637 patientyears) and 51% in non-appendectomized patients (1 454 out of 2 841 patient-years; NS). CONCLUSION:Prior appendectomy is associated with a more proximal disease and has an increased risk of stricture and a lesser risk of anal fistulization. However, the severity of the disease is unaffected.

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Section: Discussionmentioning

confidence: 99%

Prior appendectomy and the phenotype and course of Crohn’s disease

Cosnes

Seksik²,

Nion–Larmurier³

et al. 2006

WJG

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“…Infectious causes are responsible for 38% of cases, and constitute Yersinia, Mycobacterium tuberculosis and other microorganisms, e.g., parasites and fungi [12][13][14]. Yersinia infection accounts for up to 25% of GA [13].…”

Section: Discussionmentioning

confidence: 99%

“…Yersinia infection accounts for up to 25% of GA [13]. Yersinia enterocolitica and Yersinia pseudotuberculosis species are most responsible ones.…”

Section: Discussionmentioning

confidence: 99%

Granülomatöz apandisitin basit laboratuar testleriyle ilişkisi. Kontrollü gözlemsel çalışma.

Çakıt¹,

Şişik²,

Özel³

et al. 2016

Archives of Clinical and Experimental Medicine

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Aim: Granulomatous appendicitis (GA) is evaluated as different clinical situation from specific causes, and very rare. It is defined as the presence of granulomatous inflammation in the appendix. Its etiology can be infectious, or noninfectious. However its differentiation from tumor can be challenging with macroscopic appearance in the operation. In this study, we aimed to present a case series of GA cases, evaluate prediction and association of GA before surgery. Material and Methods: A descriptive study is designed. All appendectomies between 2007 and 2015 were reviewed. The patients who diagnosed with GA by histopathological evaluation constituted study group. The rest constituted the control group. Demographic data, complete blood count parameters (22 parameters for each) were recorded. Categorical variables were expressed as frequencies and percentages. Baseline characteristics were compared using the t-test and Mann-Whitney U test. Fisher's exact test was used to compare categorical variables. The differences were considered statistically significant if the p value was less than 0.05 at a 95% confidence interval. Results: During study period, 4570 patients were operated for acute abdomen with the presumptive diagnosis of acute appendicitis. Eight (0.2%) patients constituted study group. For control group sample size was calculated as 527 cases (95% power to show a 50% difference in the rate of the primary outcome, with a 2-sided type I error rate of 5%. Additional 142 to decrease errors). Demographic findings like age and gender didn't show difference between the groups (p=0.499 and p=0.477, respectively). EOS# and EOS% were higher in study group than control group (p<0.0001 and p<0.0001, respectively). Logistic regression analysis showed that EOS% effect was significant with p of <0.0001, odds ratio of 0.522 and Nagelkerke R2 of 0.191. Conclusion: Diagnosis of GA with macroscopic appearance in operation is a challenging for a surgeon. We found that EOS# and EOS% are associated with GA. Keywords: Acute appendicitis, Granulomatous appendicitis, Prediction Öz Amaç: Granülomatöz apandisit (GA), spesifik nedenler ile oluşan farklı klinik durum olarak değerlendirilir ve çok nadirdir. Apendikste granülomatöz inflamasyon varlığı olarak tanımlanmaktadır. Etiyolojisi infeksiyöz veya infeksiyon dışı olabilir. Bununla birlikte, operasyondaki makroskopik görünümüyle tümörden ayırmak zor olabilir. Bu çalışmada, GA vaka serisi sunmayı ve cerrahiden önce GA öngörüsünü ve ilişkisini değerlendirmeyi amaçladık. Araç ve Yöntemler: Tanımlayıcı bir çalışma tasarlandı. 2007 ile 2015 yılları arasındaki tüm apendektomiler gözden geçirildi. Histopatolojik değerlendirme ile GA tanısı alan hastalar çalışma grubunu oluşturdu. Geriye kalanlar kontrol grubu oluşturdu. Demografik veriler, tam kan sayımı parametreleri (her biri için 22 parametre) kaydedildi. Kategorik değişkenler frekanslar ve yüzdeler şeklinde ifade edildi. Temel özellikler, t-testi ve Mann-Whitney U testi kullanılarak karşılaştırıldı. Kategorik değişkenleri ka...

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“…The most common clinical features are those of complicated acute appendicitis (abscess, peritonitis). Only the pathological examination of specimen could confirm the appendicular Crohn's disease [22]. On the other hand, the achievement of the appendix during the ileocecal Crohn's disease is much more common (21%) and offers no clinical features [23].…”

Section: The Acute Complications Of Crohn's Diseasementioning

confidence: 99%

“…The recurrence rate is equivalent to the intestinal resection with morbidity of around 12%. This technique leaves in place an inflammatory diseased tissue and does not spare the patient from escalating therapy postoperatively to stop the inflammation [21,22].…”

Section: Stricturoplastymentioning

confidence: 99%

Surgical Management of Primary Crohn’s Disease

Makni¹

2017

Austin J Gastroenterol

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Inflammatory bowel disease is a chronic gastrointestinal condition that is characterized by chronic gastrointestinal inflammation. The management of Crohn's disease is complex and requires skill, knowledge and experience with current advances in the field. Over the past several years, there have been a number of achievements and progress made in the care and management of this disorder. The diagnostic tools have greatly improved. The therapeutic armamentarium has expanded. The genetics of IBD has become more detailed and the role of the gut microbiome has been better defined. The evolution of biological agents has revolutionized the way we approach this disease. However, surgery is still required in more than 80% of patients with Crohn's disease (CD). This article aims to study the epidemiological, anatomical and therapeutic principles of surgical forms of CD. Keywords:Crohn's disease; Surgery; Recurrence; Stricture; Fistula IntroductionSurgery is required in more than 80% of patients with Crohn's disease (CD) [1]. The aim of surgery is not to cure the disease, which evolves in most cases to the recurrence of the remaining intestine [2]. Surgical treatment of intestinal lesions caused by CD is guided by two main criteria: operate only complicated forms, and refractory to medical treatment, and perform an intestinal resection as limited as possible, removing only lesions responsible for the symptoms observed. Indeed, perineal CD is problematic as regards to the diagnostic, prognostic and specific management. Over the past several years, there have been a number of achievements and progress made in the care and management of this disorder. However, surgery is still required in more than 80% of patients with Crohn's disease (CD). This article aims to study the epidemiological, anatomical and therapeutic principles of surgical forms of CD. The indications of surgical managementMultidisciplinary approach is now mandatory to discuss the therapeutic strategy and the time for surgery. The indication for surgery in CD depends on a number of factors-complications, clinical course, relapse and location. We could say that surgery is timely in any of the following situations: failure of medical treatment, onset of specific complications related to the disease or to pharmacological treatment, dysplasia or cancer and stagnated or retarded growth in children [3,4]. Chronic complications of Crohn's diseaseSurgery in the era of medical management: Today's, medical management (immunosuppressants, biological therapies) has been used increasingly and was initiated much earlier during the course of CD. However, this evolving therapeutic strategy was not associated with a decrease in the need for surgery or in a decrease of the occurrence of intestinal complications. The real benefit is that large intestinal resections became more unusual [5].Time for surgery: Identifying the best time for surgery is not always an easy task. In order to determine the best time for surgery

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Crohn’s disease limited to the appendix

Cited by 43 publications

References 8 publications

Prior appendectomy and the phenotype and course of Crohn’s disease

Prior appendectomy and the phenotype and course of Crohn’s disease

Granülomatöz apandisitin basit laboratuar testleriyle ilişkisi. Kontrollü gözlemsel çalışma.

Surgical Management of Primary Crohn’s Disease

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