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Ulcerative appendicitis in universal and nonuniversal ulcerative colitis

G M Groisman1, J George, N Harpaz

  • 1Lillian and Henry Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, City University of New York, New York.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|April 1, 1994
PubMed
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Ulcerative appendicitis (UA) is common in ulcerative colitis (UC) colectomy specimens. This study found UA is equally prevalent in both continuous and skip lesion patterns of UC.

Area of Science:

  • Gastroenterology
  • Pathology
  • Colorectal Surgery

Background:

  • Ulcerative appendicitis (UA) is the appendix manifestation of ulcerative colitis (UC).
  • UA is typically seen in universal UC as a continuous inflammatory process.
  • The presence of UA in non-universal UC, as skip lesions, is debated.

Purpose of the Study:

  • To investigate the prevalence of ulcerative appendicitis (UA) in ulcerative colitis (UC) colectomy specimens.
  • To determine if UA occurs as skip lesions in non-universal UC.
  • To compare UA prevalence in universal versus non-universal UC.

Main Methods:

  • Histological review of 160 UC colectomy specimens (adult and pediatric).
  • Classification of UC into universal and non-universal groups based on strict histopathological criteria.

Related Experiment Videos

  • Exclusion of 45 cases with obliterated appendiceal lumens.

    • Main Results:

    • UA was present in 87% of universal UC cases (86% in adults, 64% in pediatric).
    • UA was found in 86% of non-universal UC cases (skip lesions), predominantly in adults.
    • UA was identified in cases with colitis distal to the hepatic flexure, including left-sided colitis and proctosigmoiditis.

    Conclusions:

    • Discontinuous appendiceal involvement (UA) in non-universal UC is as prevalent as continuous involvement in universal UC.
    • UA should be considered in UC involving the appendix, regardless of the extent of colon involvement.
    • Findings support UA as a significant feature in various patterns of UC.