Abstract
Aim
To present our experience of surgical management of Crohn’s disease, incidentally found during laparotomy performed for appendicitis, and also to review the literature.
Patients — methods
Between January 2009 and January 2010, a total of 49 patients underwent laparotomy following a preoperative clinical diagnosis of acute appendicitis, of whom 17 were female and 32 male, with ages ranging from 25 to 64 years (mean age 27 years). Three of these patients, two males aged 32 and 17 years and one female 35 years, presented with severe inflammation, stenosis and oedema of the terminal ileum and mesentery of the ileocaecal area. The female patient also displayed a fistula between the terminal ileum and sigmoid colon as well as two other lesions in the small intestine. All patients were subjected to an ileocaecal resection and side-to-side ileo-ascending colon anastomosis. The female patient underwent repair of the fistula on the sigmoid colon; further intervention for the two other lesions was unnecessary since the stenosis was not considered severe.
Results
Histopathologic examination confirmed the diagnosis of Crohn’s disease. No postoperative complications were observed and the patients were subsequently referred to the gastroenterologist.
Conclusion
In Crohn’s disease found at laparotomy for appendicitis, an ileocaecal resection is recommended. The follow-up and therapy of these patients is undertaken by the gastroenterologist.
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Skandalos, I., Angelopoulos, A., Margioulas, A. et al. Management of Crohn’s disease found during laparotomy for acute appendicitis. Hellenic J Surg 82, 391–396 (2010). https://doi.org/10.1007/s13126-010-0061-3
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DOI: https://doi.org/10.1007/s13126-010-0061-3