Management of the Appendix in Young Patients With Crohn's Disease

The Continuing Challenge of Acute Appendicitis

“…This dictum would seem to hold true as long as symptoms have been present for less than 1 week [102], Beyond this time the diagnosis of appendici tis must be dubious and the fistula rate is high. Some authors [103] believe that estab lished Crohn's disease rules out the possibil ity of acute appendicitis and that the compli cation rate is so high that appendicectomy is contra-indicated. Fistulas certainly do follow laparotomy in Crohn's disease, but these sel dom develop from the appendix stump.…”

Granulomatous appendicitis in a 12-year-old boy

“…Distinguishing idiopathic GA and isolated appendiceal Crohn's disease is difficult in the perioperative period. The prognosis of idiopathic GA appears to be favorable [2][3][4]21]. In our patient, granulomas (composed of epithelioid histiocytes with central necrosis) were demonstrated in the wall of appendix; but no definitive cause was detected after investigations.…”

Idiopathic Granulomatous Appendicitis Treated Surgically with Long-Term Follow-Up: Report of a Case

“…6,7 Postoperative fi stula formation or recurrence is rare in isolated appendiceal Crohn's disease, whereas it can occur in 15%-20% of the patients undergoing appendectomy for ileocecal Crohn's disease. 8 A few recent reports describe idiopathic granulomatous appendicitis as a new disease entity of isolated granulomatous infl ammation of the appendix. 2,9 Patients with idiopathic granulomatous appendicitis usually have a favorable clinical course after surgery.…”