Crohn’s Disease Presenting as Acute Appendicitis, Case Series

Abstract

Objective: Crohn's disease can be observed in younger patients and may present with a clinical condition such as acute appendicitis. In this study, we aimed to investigate acute abdominal conditions that were caused by the first attack of Crohn's disease. Methods:Patients who were admitted with the signs of acute abdomen and underwent surgery between 2009 and 2013 were included in the study. Patients diagnosed with Crohn's disease based on intraoperative findings and postoperative evaluations were included in the study. Patient demographics, findings about Crohn's disease, and follow-up data were recorded.Results: During the study period, 736 patients who had acute abdomen and a preliminary diagnosis of acute appendicitis were operated, and four of them (0.5%) were diagnosed with Crohn's disease at the peroperative or postoperative period. Two of the patients were male and the others were female; the mean age was 36 years (28-45 years). Perioperative inflammatory cecal mass and local abscesses were observed in one patient and drainage was performed. Only appendectomy was performed in the other three patients, and postoperative enterocutaneous fistula was observed in two of them.Intestinal resection was performed in one of the patient with fistula, and the other responded well to medical treatment. Conclusion:Crohn's disease may present as acute abdomen. Particularly, people without a history of the illness may come to us with such a clinical condition in the first episode; therefore, this situation should not be ignored.Routine laboratory tests, complete blood count, chemistry panel, liver function tests, inflammatory markers and serologic tests were used to support the diagnosis of CD. Imaging methods such as plain abdominal radiography, CT, and ileocolonoscopy were used. Abstract