Some patients develop a granulomatous appendicitis that may resemble appendiceal Crohn's disease.



(1) The patient with right lower quadrant pain and other clinical features of appendicitis.

(2) The clinical course may be more protracted than usual for cases of acute appendicitis.

(3) The appendix shows noncaseating granulomas with or without mucosal ulcers.


Features distinguishing the appendicitis from Crohn's disease:

(1) There is no evidence of Crohn's disease at the time of surgery, and

(2) No evidence of Crohn's disease develops later.

(3) The patient is adequately treated by appendectomy.


Findings favoring the diagnosis of Crohn's appendicitis.

(1) occurrence of an inflammatory mass in the right lower quadrant

(2) development of an enterocutaneous fistula

(3) presence of crypt abscesses


The patient should have stool cultures looking for bacteria such as Yersinia and Campylobacter species.


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