EC Gastroenterology and Digestive System

Introduction and Aim: Crohn’s disease (CD) is a chronic disease that can be revealed by an acute appendiceal syndrome. The aim of the work was to identify the particularities and analyze patients with Crohn’s disease revealed by an appendicular syndrome.

Materials and Methods: This is a retrospective and descriptive study of patients with CD revealed by an appendicular syndrome over a period of 6 years in our unit.

Results: 31 patients were collected out of 163 patients with CD. The average age was 29 years, with a sex ratio F/M of 1,12. 19 patients presented with a non complicated appendicitis, 11 patients with appendiceal abscess and 1 patient with an appendicular peritonitis. 17 patients underwent ileocecal resection in emergency. 10 patients underwent emergency appendectomy, complicated in 2 patients by an enterocutaneous fistula, 1 patient with a deep abscess, 3 patients with a deep abscess fistulized at the abdominal wall, 2 patients with an ileal stenosis, 1 patient of an ileocecal mass and 1 patient of micro-abscess of the right iliac fossa. 4 patient was not operated in emergency, put under medical treatment with good evolution. Mean CDAI was 262, being higher in emergency operated patients. Rutgeerts in the operated patients were higher in those operated on urgently (i3 i4), i0 i1 in the rest of the patients.

Conclusion: In patients with CD revealed by an appendicular syndrome, the activity of this disease seems high especially in patients operated in emergency.

Keywords: Crohn’s Disease (CD); Appendicular Syndrome

1. Nugent FW. “Crohn’s disease of the appendix”. The American Journal of Gastroenterology 65 (1976): 83.
2. Gilaad G and Kaplan MD. “The Risk of Developing Crohn’s Disease After an Appendectomy: A Meta-Analysis”. American Journal of Gastroenterology (2008).
3. Richards ML., et al. “Granulomatous appendicitis: Crohn’s disease, atypical Crohn and #39;s, or not Crohn’s at all?” Journal of the American College of Surgeons 185 (1997): 13-17.
4. Ruiz V., et al. “Crohn’s disease of the appendix”. Surgery 1 (1990):07: 113-117.
5. Loureiro AC and Barbosa LE. “Appendectomy And Crohn’s Disease”. Journal of Coloproctology (2018).
6. Riegler G., et al. “Worse clinical course of disease in Crohn’s patients with previous appendectomy”. European Journal of Gastroenterology and Amp; Hepatology6 (2005): 623-627.
7. Caserta L., et al. “Relationship between anamnestic evidence of appendectomy and onset and clinical course of Crohn’s disease”. The American Journal of Gastroenterology1 (2002): 207.
8. Andersson RE., et al. “Appendectomy is followed by increased risk of Crohn’s disease”. Gastroenterology 1 (2003): 40-46.
9. Koepsell TD. “In search of the causes of appendicitis”. Epidemiology 2 (1991): 319-321.
10. Arnbjornsson E and Bengmark S. “Role of obstruction in the pathogenesis of acute appendicitis”. The American Journal of Surgery 147 (1984): 390-392.