A Case Report of Crohn's Disease of the Appendix

Toshihiro Morita, Toshio Yamauchi, Iwao Kumazawa, Masahiro Katada, Shin Yamada, Shigetoyo Saji*

Department of Surgery, Sumi Hospital
*Second Department of Surgery, Gifu University School of Medicine

Crohn's disease confined to the appendix is rare and we found reports of only 10 other cases in Japan. We present a case of Crohn's disease of the appendix in a 20-year-old man. He was admitted to our hospital with complaints of pain in the right lower quadrant. Physical examination at that time had revealed rebound tenderness and muscle guarding of the right lower quadrant of the abdomen. Abdominal ultrasonography and an abdominal CT scan revealed a swollen tumor shadow in the ileocecal region. The preoperative impression was appendicitis. A laparotomy was performed and the appendix was found to be inflamed, and markedly enlarged (35×30 mm). An appendiceal tumor could not be excluded and ileocolectomy with D2 lymphnode clearing was performed. Histologically, the specimen had a fullthickness appendiceal wall showing inflammation with lymphoid aggregation, a fissuring ulcer and non-caseating small granuloma. As a result of histologically findings, we diagnosed this as a case of Crohn's disease of the appendix. He has had no sign of recurrence of the disease for a 2-year follow-up period.

Key words
Crohn's disease of the appendix, Crohn's disease

Reprint requests
Toshihiro Morita Department of Surgery, Sumi Hospital
2-1 Shirotori-cho, Gujo-gun, 501-5121 JAPAN

Accepted
September 16, 1998

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