Crohn's disease confined to the appendix

Abstract

Crohn's disease confined to the appendix is a rare entity, less than 50 cases having been reported. The present study reports on another 12 cases representing 6 per cent of all 194 patients operated upon for Crohn's disease in a total, unselected series. The indications for surgery were appendicitis in eight patients, appendiceal abscess in two, suspected pyosalpinx in one, and an ovarian cyst in one. The appendices were in all cases strikingly enlarged. Giant-cell granulomas, without microabscesses were detected in all but one patient. Two patients had early septic postoperative complications. Fistulization from the cecum did not occur. The median observation time after operation was 13.8 years. Since none of the patients had further manifestations of the disease, it is concluded that patients with Crohn's disease confined to the appendix have a favorable prognosis.

Isolated Crohn's Disease of the Appendix

“…Subse¬ quently, this theory has been disproved, as patients with Crohn's disease often have involvement of the colon and appendix.8 In 1953, Meyerding reported the first case of isolated Crohn's disease of the appendix.19 Since that time there have been many sporadic case reports,* and some collective reviews. 1,9,14,16,19,2°A marked variation in rates of occurrence, complications, and recurrence was found. In¬ cluding our two cases, 75 cases of isolated Crohn's disease of the appendix have been reported in the world literature.…”

“…The differential diagnosis includes tuberculosis, sarcoidosis, foreign-body reaction, diverticulitis of the ap¬ pendix or cecum, and infections with parasites, actinomycosis, and Yersinia organisms. 1,9,10,20 Tuberculosis of the appendix usually forms caseating granulomas and is often present elsewhere in the body, such as in the lungs. Histologically, the granulomatous reaction is usually more confluent and less discrete than in Crohn's disease.1 Acid-fast bacillus stains, cultures, and purified protein derivative skin tests aid in excluding this diagnosis.…”

Granulomatous Appendicitis Revisited: Report of a Case

“…Crohn’s disease is a chronic relapsing condition several previous series have noted that, when confined to the appendix, it has a favourable prognosis including infrequent recurrence [7]. Indeed review of the literature shows that 6% of patients with granulomatous appendicitis will relapse whereas recurrence after primary bowel resection for typical Crohn’s disease is around 50% [8].…”

Laparoscopic Appendectomy for Crohn's Disease of the Appendix Presenting as Acute Appendicitis

“…7 Operations described in the literature for this disease include open appendectomy, appendectomy with cecectomy, and ileocolic resection. [1][2][3][4][5][6] We report the first case of CD of the appendix presenting as acute appendicitis treated by laparoscopic appendectomy.…”

“…[1][2][3][4][5][6] Although CD is generally a chronic disease of the gastrointestinal tract, some authors have reported no recurrences as much as 7 years after appendectomy for CD of the appendix. 7 Operations described in the literature for this disease include open appendectomy, appendectomy with cecectomy, and ileocolic resection.…”