Endoscopy 2012; 44(01): 95-98
DOI: 10.1055/s-0031-1291443
Case report/Series
© Georg Thieme Verlag KG Stuttgart · New York

Long term follow-up of appendiceal and distal right-sided colonic inflammation

S. H. Park
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
S. K. Yang
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
M. J. Kim
2   Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
D. H. Yang
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
K. W. Jung
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
K. J. Kim
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
B. D. Ye
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
J. S. Byeon
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
S. J. Myung
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
J. H. Kim
1   Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
› Author Affiliations
Further Information

Publication History

Submitted: 27 April 2011

Accepted after revision: 14 September 2011

Publication Date:
23 December 2011 (online)

The aim of this study was to investigate the possibility of appendiceal orifice inflammation (AOI) as a preceding lesion in the development of ulcerative colitis. A total of 20 patients were identified (mean age 41.2 years; 11 males) who had ulcerative colitis-like inflammatory lesions at the appendiceal orifice without concomitant typical features of ulcerative colitis, such as rectal involvement. A total of 19 patients were followed up endoscopically for a mean duration of 18.4 months (range 2 – 84 months). Typical ulcerative colitis developed in five patients (25 %; four proctitis, one pancolitis) in a mean time of 18.4 months (range 2 – 36 months). Negative conversion of all inflammatory lesions occurred in seven patients (35 %) after a mean follow-up of 20 months (range 3 – 84 months). In the remaining seven patients (35 %), initial lesions did not progress to ulcerative colitis and did not go into remission during a mean follow-up of 16.9 months (range 2 – 42 months). These results suggest that, at least in some cases, AOI precedes development of ulcerative colitis.

 
  • References

  • 1 Pera A, Bellando P, Caldera D et al. Colonoscopy in inflammatory bowel disease. Diagnostic accuracy and proposal of an endoscopic score. Gastroenterology 1987; 92: 181-185
  • 2 Groisman GM, George J, Harpaz N. Ulcerative appendicitis in universal and nonuniversal ulcerative colitis. Mod Pathol 1994; 7: 322-325
  • 3 Kroft SH, Stryker SJ, Rao MS. Appendiceal involvement as a skip lesion in ulcerative colitis. Mod Pathol 1994; 7: 912-914
  • 4 D’Haens G, Geboes K, Peeters M et al. Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study. Am J Gastroenterol 1997; 92: 1275-1279
  • 5 Yang SK, Jung HY, Kang GH et al. Appendiceal orifice inflammation as a skip lesion in ulcerative colitis: an analysis in relation to medical therapy and disease extent. Gastrointest Endosc 1999; 49: 743-747
  • 6 Takizawa H, Yamaguchi O, Kaizu M et al. A case of appendiceal lesion prior to the manifestation of ulcerative colitis: so-called “ulcerative appendicitis” as an antecedent lesion. Jpn J Gastroenterol 1996; 93: 109-113
  • 7 Kang K, Kim H, Chang Y et al. A case of atypical ulcerative colitis initially presented as the appendiceal lesion. Korean J Gastrointest Endosc 1999; 19: 971-974
  • 8 Nagase K, Tosa M, Oriuchi T et al. A case of ulcerative colitis preceding the so-called “ulcerative appendicitis”. Stomach Intestine (Tokyo) 2009; 44: 1602-1606
  • 9 Joo M, Odze RD. Rectal sparing and skip lesions in ulcerative colitis: a comparative study of endoscopic and histologic findings in patients who underwent proctocolectomy. Am J Surg Pathol 2010; 34: 689-696
  • 10 Byeon JS, Yang SK, Myung SJ et al. Clinical course of distal ulcerative colitis in relation to appendiceal orifice inflammation status. Inflamm Bowel Dis 2005; 11: 366-371