A Case of ldiopathic Granulomatous Appendicitis

Hirofumi Uchino, Ryo Sekiya, Masayoshi Nishitani, Junichi Shiiba, Yasunori Matsuzaki, Makoto Tanigawa, Toshio Onitsuka, Kouichirou Shibata, Yasunori Koga

Second Department of Surgery, Miyazaki Medical College

A case of idiopathic granulomatous appendicitis is reported. An 8-year-old girl complained of right lower quadrant pain two weeks before admission. She was admitted to our hospital with loss of appetite and high fever. Preoperative ultrasonographic examination revealed thickening of the appendiceal wall surrounded with a low echoic space. The patient was diagnosed with appendicitis with local abscess, and an appendectomy was performed. A small amount of turbid ascitic fluid was observed in the peritoneal cavity. The appendix was greatly swollen (7×3 cm) with local abscess formation. The rest of gastrointestinal tract was normal in appearance. Histopathological examination showed multiple granulomas composed of epitheloid cells and multinucleated giant cells mainly in the submucosal layer of the resected tissue, suggesting idiopathic granulomatous appendicitis. The patient's clinical course was satisfactory and she was discharged on the 13th postoperative day.

Key words
idiopathic granulomatous appendicitis, appendix, granuloma

Reprint requests
Hirofumi Uchino Second Department of Surgery, Miyazaki Medical College
5200 Kiwara, Kiyotake, Miyazaki, 889-16 JAPAN

Accepted
April 3, 1996

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