Related Experiment Videos
The appendix in inflammatory bowel disease in children
1Department of Laboratories, North Shore University Hospital, Cornell University Medical College, Manhasset, New York.
Insights
In pediatric inflammatory bowel disease (IBD), appendiceal involvement is common, with specific changes seen in over half of Crohn's disease and ulcerative colitis cases. All examined appendices showed abnormalities, indicating significant appendiceal pathology in children with IBD.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
- Inflammatory Bowel Disease
Background:
- Appendiceal pathology in pediatric inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is not well-defined.
- The frequency of appendiceal involvement in children with IBD requires further delineation.
Purpose of the Study:
- To determine the prevalence of appendiceal involvement in children with IBD requiring colonic resection.
- To define the histopathologic characteristics of the appendix in pediatric CD and UC.
Main Methods:
- Retrospective analysis of 41 children with IBD (24 CD, 17 UC) who underwent colonic resection.
- Histopathologic examination of all resected appendices.
Main Results:
- All appendices examined (100%) exhibited abnormalities.
- Specific histopathologic changes consistent with CD or UC were identified in 50% and 56% of appendices, respectively.
- Nonspecific changes, including fibrosis and hyperplasia, were observed in the remaining appendices. The severity of inflammation in the ileocolon and appendix was similar in approximately two-thirds of patients.
Conclusions:
- Appendiceal involvement is a consistent finding in children with IBD requiring colonic resection.
- Both specific and nonspecific appendiceal changes are prevalent in pediatric IBD, highlighting the appendix as a site of inflammation.
- The appendix should be considered in the evaluation of pediatric IBD patients, as it frequently displays characteristic or nonspecific inflammatory changes.
Abstract:
The morphologic characteristics of the colon in ulcerative colitis and Crohn's disease are well established, but specific appendiceal pathology is less clearly defined. In addition, the frequency of appendiceal involvement in children with inflammatory bowel disease has also not been delineated. We have determined the prevalence of appendiceal involvement in 41 children with inflammatory bowel disease (24 with Crohn's disease and 17 with ulcerative colitis) who required colonic resection and have defined the histopathologic characteristics of the appendix in these diseases. All appendices were abnormal. Specific changes of Crohn's disease or ulcerative colitis were observed respectively in 50% and 56% of the appendices in our patient population. Nonspecific changes only such as fibrous obliteration, serosal fibrosis and lymphoid and/or neuronal hyperplasia were noted in the remaining appendices. The severity of ileocolonic and appendiceal inflammation was similar in about two thirds of the patients with either type of inflammatory bowel disease.