scholarly journals Postoperative complicated appendectomy revealing Crohn’s disease in a pediatric patient

2021 ◽  
Vol 8 (1) ◽  
pp. 154-160
Author(s):  
Augustina Enculescu ◽  
Mircea Lupusoru ◽  
Catalin Cirstoveanu ◽  
Andra-Iulia Suceveanu ◽  
Liliana Andronache ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Pediatric Population ◽  
Pathological Examination ◽  
Ileocecal Resection ◽  
Initial Manifestation ◽  
Adequate Treatment ◽  
Granulomatous Appendicitis

Granulomatous appendicitis is a very rare entity in children. It is related to Crohn’s disease in only 5-10% of the cases. The diagnosis of Crohn’s disease is a real challenge in the pediatric population, especially when its initial manifestation is acute appendicitis. Herein, we present a 13-year-old boy admitted for acute appendicitis. The histopathological examination was conclusive for acute granulomatous appendicitis. The development of an entero-cutaneous fistula has complicated the postoperative evolution. The failure of the conservative management required ileocecal resection. The pathological examination revealed Crohn’s disease. The one-year follow-up on the patient din not reveal any complications. We strongly support the importance of the histopathological examination of the entirely removed appendix. Careful assessment of granulomatous appendicitis is needed in order to establish its possible etiology and to initiate the adequate treatment.

Granulomatous Appendicitis in the Pediatric Population

2019 ◽  
Vol 23 (3) ◽  
pp. 215-221
Author(s):  
Hao Wu ◽  
Maren Y Fuller ◽  
Jennifer Pogoriler
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Diagnostic Yield ◽  
Pediatric Population ◽  
Clinical Care ◽  
Perforated Appendicitis ◽  
Interval Appendectomy ◽  
Time Period ◽  
Common Etiology ◽  
Granulomatous Appendicitis

Background The clinical significance of a diagnosis of granulomatous appendicitis (GA) is not well established in the pediatric population. Methods Retrospective review of the etiology and histopathology of pediatric GA at 2 large pediatric institutions. Results Forty-three (0.4%) patients had GA at a median age of 12.1 years. Twenty-two (51%) had perforated appendicitis that was medically managed prior to interval appendectomy. Sixteen of 21 noninterval appendectomies were performed for clinically suspected acute appendicitis. Among them, 1 had Crohn’s disease identified during surgery. None of the other patients had a subsequent diagnosis of inflammatory bowel disease (median follow-up of 4 weeks). There were significantly more cases with mucosal-only granulomas as well as fewer serosal granulomas in the noninterval appendectomy specimens than the interval specimens ( P = .014). When performed, special stains for microorganisms did not contribute to clinical care. In the same time period, GA was seen in 6 (6%) of 94 bowel resections for Crohn’s disease. Conclusion GA is rare in pediatric patients, with interval appendectomy being the most common etiology and only rarely associated with Crohn’s disease. Granulomas in interval appendectomies tend to be serosal-based. Special stains for infectious organisms in GA are of low diagnostic yield and have little impact on clinical management.

scholarly journals Crohn’s Disease Presenting as Granulomatous Appendicitis

2019 ◽  
Vol 13 (3) ◽  
pp. 398-402
Author(s):  
Ryota Otsuka ◽  
Koichi Shinoto ◽  
Yasushi Okazaki ◽  
Kota Sato ◽  
Atsushi Hirano ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Conservative Treatment ◽  
Histopathological Examination ◽  
Open Appendectomy ◽  
Lower Abdominal Pain ◽  
Granulomatous Inflammation ◽  
Careful Examination ◽  
Specific Staining ◽  
Granulomatous Appendicitis

Granulomatous appendicitis is uncommon. It can be caused by infectious or systemic disorders, such as Crohn’s disease (CD) and sarcoidosis. It is therefore essential to investigate systematic causes of granulomatous appendicitis after surgery by appropriate examinations. It is also rare for acute appendiceal inflammation to develop due to active CD. We herein report a case of CD presenting as granulomatous appendicitis. The patient was a 28-year-old man who arrived at the emergency room with right lower abdominal pain. Computed tomography showed a low-density lesion with a clear boundary and a small high-density spot in its center behind the cecum. Acute appendicitis with abscess formation was suspected and conservative treatment was started. After 3 consecutive days of conservative treatment there was no improvement in his condition. We therefore performed open appendectomy. Histopathological examination showed numerous noncaseous epithelioid granulomas in the wall of the appendix. Specific staining revealed no evidence of acid-fast bacilli or fungi. During follow-up after discharge, colonoscopy demonstrated erosion from the cecum to the transverse colon. A colon biopsy showed severe inflammation with cryptitis, Paneth cells, and a granulomatous lesion. The patient was therefore diagnosed with CD and treatment with mesalazine was started. Careful examination is necessary to diagnose and properly treat patients with granulomatous inflammation of the appendix.

scholarly journals AggressiveHelicobacter pylori-negative peptic ulceration as the initial manifestation of Crohn's disease

2012 ◽  
Vol 3 (3) ◽  
pp. 201-205 ◽  
Author(s):  
James Callaghan ◽  
Sarah Brown ◽  
Tim Battcock ◽  
Sally Parry ◽  
Jonathon Snook
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Peptic Ulceration ◽  
Initial Manifestation

scholarly journals Pulmonary Crohn's Disease in Down Syndrome: A Link or Linkage Problem

2016 ◽  
Vol 10 (2) ◽  
pp. 206-211
Author(s):  
Danyal Thaver ◽  
Mirza Beg
Keyword(s):  
Down Syndrome ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pediatric Population ◽  
Pulmonary Nodules ◽  
Pulmonary Involvement ◽  
Lung Nodules ◽  
Inflammatory Disorder ◽  
Ct Guided ◽  
History Of

Crohn’s disease (CD) is an autoimmune inflammatory disorder that primarily affects the gastrointestinal tract. It may have pulmonary involvement, which has been rarely reported in pediatric patients. Down syndrome (DS) has been associated with increased frequency of autoimmune diseases. However, associations between CD and DS have been rarely reported. We present the case of a 5-year-old girl with known DS and a history of chronic intermittent abdominal pain who presented with persistent pneumonia. Her workup included a chest computed tomography (CT) scan that showed multiple noncalcified pulmonary nodules. An extensive infectious workup was done that was negative. CT-guided needle biopsy of the lung nodules showed necrotizing granulomas. This raised concern for primary CD with extraintestinal pulmonary manifestation. An esophagogastroduodenoscopy and colonoscopy were performed, and colon biopsies showed scattered epithelioid granulomas. Based on this information, there was consensus that her lung nodules were secondary to CD. She was started on standard therapy for CD, and her abdominal and respiratory symptoms gradually improved. However, she continues to have mild residual lung calcification and fibrosis. To our knowledge, this is the first reported case of pulmonary CD in a child with DS. The natural history of pulmonary CD in the pediatric population is not very well studied. Furthermore, since DS has been well known to be associated with increased frequency of malignancies and autoimmune conditions due to immune dysregulation, it is difficult to predict the severity and possible complications in this patient.

scholarly journals Predictive value of tissue calprotectin for disease recurrence after ileocecal resection in pediatric Crohn's disease

2021 ◽  
Author(s):  
Kristyna Zarubova ◽  
Ondrej Fabian ◽  
Ondrej Hradsky ◽  
Tereza Lerchova ◽  
Filip Mikus ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Predictive Value ◽  
Disease Recurrence ◽  
Ileocecal Resection

Mucosal Recolonization after Ileocecal Resection Differs in Crohn's Disease Patients Developing Postoperative Recurrence

2017 ◽  
Vol 152 (5) ◽  
pp. S990
Author(s):  
Kathleen Machiels ◽  
Marta Pozuelo del Río ◽  
João Sabino ◽  
Alba Santiago ◽  
David Campos ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Ileocecal Resection

Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study

2015 ◽  
Vol 50 (10) ◽  
pp. 1630-1635 ◽  
Author(s):  
Iva Hojsak ◽  
Sanja Kolacek ◽  
Lars Folmer Hansen ◽  
Jiri Bronsky ◽  
Maija Piekkala ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileocecal Resection ◽  
European Study ◽  
Long Term Outcomes

Crohn’s disease of the gallbladder

2021 ◽  
Vol 14 (9) ◽  
pp. e243579
Author(s):  
Callam Scott ◽  
Amit Patel ◽  
Noori Maka ◽  
Jonathan C MacDonald
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Gallstone Formation ◽  
Right Hemicolectomy ◽  
Chronic Cholecystitis ◽  
Pathological Examination ◽  
Key Factors ◽  
Chronic Inflammatory Condition ◽  
History Of ◽  
Lymphoid Aggregates

Crohn’s disease (CD) is a chronic inflammatory condition, which typically involves the small and large bowel but can affect any part of the gastrointestinal tract. Common symptoms include abdominal pain, diarrhoea, fatigue, weight loss and malnutrition. Complications of CD include gallstone formation and cholecystitis. Impaired reabsorption of bile salts in the small bowel and CD-related surgeries are key factors in the development of CD-related gallstones, although other factors are also important. Direct CD-related inflammation of the gallbladder is very unusual and the typical histological features of CD are rarely encountered in cholecystectomy specimens of individuals with CD. We present a case of a man in his early 60s with CD, previous right hemicolectomy and a history of gallstones, who presented with chronic cholecystitis. Following cholecystectomy, pathological examination of the gallbladder unexpectedly demonstrated typical features of CD, including lymphoid aggregates and non-caseating mucosal granulomata.

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