Crohn's Disease Presenting as Granulomatous Appendicitis.
Appendectomy
Appendix
Crohn's disease
Granulomatous appendicitis
Journal
Case reports in gastroenterology
ISSN: 1662-0631
Titre abrégé: Case Rep Gastroenterol
Pays: Switzerland
ID NLM: 101474819
Informations de publication
Date de publication:
Historique:
received:
16
08
2019
accepted:
04
09
2019
entrez:
17
10
2019
pubmed:
17
10
2019
medline:
17
10
2019
Statut:
epublish
Résumé
Granulomatous appendicitis is uncommon. It can be caused by infectious or systemic disorders, such as Crohn's disease (CD) and sarcoidosis. It is therefore essential to investigate systematic causes of granulomatous appendicitis after surgery by appropriate examinations. It is also rare for acute appendiceal inflammation to develop due to active CD. We herein report a case of CD presenting as granulomatous appendicitis. The patient was a 28-year-old man who arrived at the emergency room with right lower abdominal pain. Computed tomography showed a low-density lesion with a clear boundary and a small high-density spot in its center behind the cecum. Acute appendicitis with abscess formation was suspected and conservative treatment was started. After 3 consecutive days of conservative treatment there was no improvement in his condition. We therefore performed open appendectomy. Histopathological examination showed numerous noncaseous epithelioid granulomas in the wall of the appendix. Specific staining revealed no evidence of acid-fast bacilli or fungi. During follow-up after discharge, colonoscopy demonstrated erosion from the cecum to the transverse colon. A colon biopsy showed severe inflammation with cryptitis, Paneth cells, and a granulomatous lesion. The patient was therefore diagnosed with CD and treatment with mesalazine was started. Careful examination is necessary to diagnose and properly treat patients with granulomatous inflammation of the appendix.
Identifiants
pubmed: 31616234
doi: 10.1159/000503170
pii: crg-0013-0398
pmc: PMC6792421
doi:
Types de publication
Case Reports
Langues
eng
Pagination
398-402Informations de copyright
Copyright © 2019 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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