medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2012, Number 2

<< Back Next >>

Cir Gen 2012; 34 (2)

Crohn’s appendicitis, presentation of a new case

Gutiérrez RE, Soto PJA, Ledesma BR, Estrada HD, Martínez RRP, Durán VFI

Language: Spanish
References: 11
Page: 134-137
PDF size: 113.65 Kb.


ABSTRACT

Objective: To report a case of appendicular and cecal Crohn disease presenting as acute appendicitis.
Setting: Second level health care hospital.
Design: Case presentation.
Case description: Woman, 33-year-old, with a 48-h abdominal pain, in the right iliac fossa, accompanied by nausea, diminished peristalsis, and peritoneal irritation. A 6 x 7 cm palpable mass was felt in the right iliac fossa. During laparotomy, a tumor was found in the cecum that involved the appendix, the ileo-cecal valve and the epiploon; a right hemicolectomy was performed. The histopathological examination indicated Crohn’s disease.
Conclusion: Presurgical diagnosis of Crohn’s appendicitis is difficult, with a 1.8% incidence. The reported case had only one pain episode and the clinical and radiological characteristics were suggestive of an acute appendicitis, without Crohn’s disease symptomatology. The presurgical diagnosis of Crohn’s disease must be suspected in the patient with recurrent pain of the right iliac fossa, with a palpable mass in the same region and an ultrasound revealing a hypoechoic image.


REFERENCES

  1. Sierra-Montenegro E, Villanueva-Sáenz E, Rocha-Ramírez JL, Pérez-Aguirre J, Fernández-Rivero JM, Soto-Quirino R. Apendicitis aguda sin enfermedad de Crohn en un paciente con inflamación intestinal. Informe de un caso. Cir Ciruj 2008; 76: 257-259.

  2. Shaoul R, Rimar Y, Toubi A, Mogilner J, Polak R, Jaffe M. Crohn’s disease and recurrent appendicitis: a case report. World J Gastroenterol 2005; 11: 6891-6893.

  3. Prieto-Nieto I, Pérez-Robledo JP, Hardisson D, Rodríguez-Montes JA, Larrauri-Martínez J, García-Sancho-Martín L. Crohn’s disease limited to the appendix. Am J Surg 2001; 182: 531-533.

  4. Masuo K, Yasui A, Nishida Y, Kumagai K. A case of Crohn’s disease limited to the appendix, showing a portentous ultrasonographic finding. J Gastroenterol 1994; 29: 76-79.

  5. Michelassi F, Hurst RD, Fichera A. Enfermedad de Crohn. En: Zinner MJ, Ashley SW, editores. Operaciones abdominales. 11ª ed. McGraw-Hill, México; 2008: 521-550.

  6. Khor B, Gardet A, Xavier RJ. Genetics and pathogenesis of inflammatory bowel disease. Nature 2011; 474: 307-317.

  7. Gómez HE, Hermosillo SJM, Candelas del Toro O. Enfermedades inflamatorias del intestino delgado. En: Aguirre RR, Athié AAJ, Ayala LE, Banderas TDA, Campos CSF, Castellanos MJA, et al. Tratado de Cirugía General. 2ª ed. Manual Moderno, México; 2008: 695-698.

  8. Agha FP, Ghahremani GG, Panella JS, Kaufman MW. Appendicitis as the initial manifestation of Crohn’s disease: radiologic features and prognosis. AJR Am J Roentgenol 1987; 149: 515-518.

  9. Gore RM, Balthazar EJ, Ghahremani GG, Miller FH. CT features of ulcerative colitis and Crohn’s disease. AJR Am J Roentgenol 1996; 167: 3-15.

  10. Jung SA. Differential diagnosis of inflammatory bowel disease: what is the role of colonoscopy? Clin Endosc 2012; 45: 254-262.

  11. Stein R, Hanauer S. Medical therapy for inflammatory bowel disease. Gastroenterol Clin North Am 1999; 28: 297-321.




2020     |     www.medigraphic.com