The clinical relevance of an inflamed appendix in Crohn's disease.

van der Does de Willebois, Eline M L; Sari, Cagla; Mookhoek, Aart; Joustra, Vincent; van Dieren, Susan; D'Haens, Geert R; Bemelman, Willem A; Buskens, Christianne J (2024). The clinical relevance of an inflamed appendix in Crohn's disease. Journal of Crohn's & colitis, 18(6), pp. 812-817. Oxford University Press 10.1093/ecco-jcc/jjad202

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BACKGROUND AND AIMS

An appendectomy for appendiceal inflammation has been suggested to ameliorate the clinical course of patients with ulcerative colitis (UC). In contrast, for Crohn's disease (CD) an inverse association has been suggested with a higher incidence of CD and worse prognosis after appendectomy. The aim of this study was to analyse the clinical relevance of an inflamed appendix in CD patients undergoing ileocoecal resection (ICR).

METHODS

All consecutive patients undergoing primary ICR between 2007 and 2018 were considered for inclusion. Microscopic data of available appendiceal resection specimens (n=99) were revised by a dedicated IBD-pathologist and scored as inflamed or not inflamed. Eighteen patients had a previous appendectomy. Pathological findings were correlated with disease characteristics and recurrence rates (clinical, endoscopic and intervention-related).

RESULTS

In total, 117 patients were included: 77 (65.8%) females with a median age of 30 years [IQR 24 - 43] with a median follow up of 102 months [IQR 76-114]. Of patients without previous appendectomy (n=99), 39% had an inflamed appendix. No significant differences in disease characteristics (e.g. disease location, behaviour, time to surgery) or prognosis could be demonstrated between the two groups. In contrast, previous appendectomy (n=18) was associated with penetrating disease and numerically shorter disease duration at the time of resection. Furthermore, a trend was seen towards a stronger association with postoperative recurrence.

CONCLUSION

The current study could not confirm a different prognosis for CD patients with and without an inflamed appendix. In contrast, in patients with a previous appendectomy a trend was seen towards increased postoperative recurrence, which might be related to the higher incidence of penetrating disease.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Mookhoek, Aart

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1876-4479

Publisher:

Oxford University Press

Language:

English

Submitter:

Pubmed Import

Date Deposited:

04 Dec 2023 15:42

Last Modified:

05 Jun 2024 00:12

Publisher DOI:

10.1093/ecco-jcc/jjad202

PubMed ID:

38039348

Uncontrolled Keywords:

Crohn’s disease appendicular inflammation ileocolic resection

BORIS DOI:

10.48350/189779

URI:

https://boris.unibe.ch/id/eprint/189779

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