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[The role of appendectomy in the ulcerative colitis in Mexico]
K Picazo-Ferrera1, Y Bustamante-Quan, J Santiago-Hernández
1Escuela de Medicina, Universidad Panamericana. México, D.F.
Introduction:
Ulcerative colitis (UC) is an inflammatory bowel disease with an unknown etiology. There have been negative suggestions relating appendectomy and UC, although there are no studies that correlate the time where the appendectomy was performed with the clinical course of the disease.
Objective:
To analyze the relationship between appendectomy and the clinical behavior in Mexican patients with ulcerative colitis.
Methods:
From January 2007 to June 2010, 114 patients with UC were analyzed. Clinical and demographic data were collected from medical records. The patients were classified in two groups: cases (UC patients with appendectomy) and controls (UC patients without appendectomy).
Results:
Among cases 42.1% needed colectomy vs. 15.7% in the control group (p = 0.003, OR = 3.59, CI = 1.36 - 9.63). Eighteen patients (47.3%) with appendectomy presented extraintestinal manifestations including arthropathy (36.8%) and primary sclerosing cholangitis (10.5%). Extraintestinal manifestations were more frequent in patients with appendectomy prior to the diagnosis of UC (41.6%), compared to 5.5% of the patients with appendectomy after the UC diagnosis (p = 0.02, OR = 6.75, CI = 1.2 - 57.7).
Conclusion:
Appendectomy in Mexican patients with UC is associated with more aggressive course of the disease and this translated in a higher risk for colectomy. An additional finding was that appendectomy prior to the diagnosis of UC is related with the development of extraintestinal manifestations.
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