Crohn's disease confined to the appendix.

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Crohn's disease (CD) is a chronic inflammatory bowel disease.
• Appendiceal involvement in Crohn's disease is exceptionally rare, with fewer than 50 reported cases.
• This study investigates a series of patients with isolated appendiceal Crohn's disease.

Purpose of the Study:

• To report on a series of 12 cases of Crohn's disease confined to the appendix.
• To analyze the clinical presentation, surgical indications, and pathological findings.
• To evaluate the long-term prognosis of patients with this rare condition.

Main Methods:

• Retrospective review of 12 patients with histologically confirmed isolated appendiceal Crohn's disease.
• Analysis of surgical indications, operative findings, and postoperative outcomes.
• Long-term follow-up to assess disease progression and recurrence.

Main Results:

• 12 cases represented 6% of all operated Crohn's disease patients.
• Surgical indications included appendicitis (8), appendiceal abscess (2), suspected pyosalpinx (1), and ovarian cyst (1).
• Appendices were enlarged; giant-cell granulomas were found in all but one case. Two patients had early septic complications. No cecal fistulization occurred. Median follow-up was 13.8 years.

Conclusions:

• Crohn's disease confined to the appendix is a rare but distinct entity.
• Patients with isolated appendiceal Crohn's disease demonstrate a favorable prognosis.
• No further disease manifestations were observed in the long term, suggesting localized disease.