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Appendiceal involvement as a skip lesion in ulcerative colitis

S H Kroft1, S J Stryker, M S Rao

  • 1Department of Pathology, Northwestern University Medical School, Chicago, Illinois.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|December 1, 1994
PubMed
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Ulcerative colitis (UC) can affect the appendix as a "skip lesion," appearing without cecal involvement. This study found ulcerative appendicitis (UA) in 15% of UC specimens, challenging traditional views of UC progression.

Area of Science:

  • Gastroenterology
  • Pathology
  • Surgical Pathology

Background:

  • Ulcerative colitis (UC) is a common inflammatory bowel disease.
  • The typical progression of UC involves continuous spread from the rectum.
  • Controversy exists regarding discontinuous UC patterns and appendiceal involvement.

Purpose of the Study:

  • To investigate appendiceal pathology in UC patients.
  • To determine the frequency of ulcerative appendicitis (UA) as a
  • skip lesion
  • in UC.

Main Methods:

  • Retrospective analysis of 39 proctocolectomy specimens from UC patients.
  • Histological examination of appendices and ceca.
  • Comparison of appendiceal and cecal disease activity.

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Main Results:

  • 51% of appendices showed active disease; 10% had quiescent disease.
  • Histological concordance between appendix and cecum was observed in 16 cases.
  • 15% of UC specimens exhibited UA as a
  • skip lesion
  • with normal or nonspecific cecal histology.

Conclusions:

  • Ulcerative appendicitis can occur as a discontinuous
  • skip lesion
  • in UC.
  • This finding challenges the notion of continuous UC progression.
  • Appendiceal pathology assessment is crucial in UC diagnosis and management.