Abstract
Four patients with Crohn’s disease limited initially to the appendix, treated by appendectomy and seen at the University of British Columbia Hospital, Vancouver, during 1980-90 are described. In all patients the initial diagnosis was based on the presence of an appendiceal granulomatous inflammatory process, while other causes such as sarcoidosis, tuberculosis and bacterial gut pathogens were excluded. While post appendectomy complications, including enterocutaneous fistula, did not occur, symptomatic recurrence was later observed in three patients four to 24 months following appendiceal resection. This recurrence was associated with a diagnosis of recurrent Crohn’s disease and histological findings of granulomas elsewhere in the gastrointestinal tract. In conclusion, a ‘reagent grade’ population of patients with Crohn’s disease limited to the appendix was seen. A high frequency of recurrent disease was defined, indicating that isolated granulomarous appendicitis may be the initial and sole presenting feature of Crohn’s disease.