Granulomatous Appendicitis: Case Report

ABSTRACT

Granulomatous appendicitis is rare and occurs in less than 2% of appendectomy materials. Granulomatous appendicitis has many infectious and non-infectious causes. Physical examination revealed rebound and defense in a 22-year-old male patient who was admitted to the emergency department with complaints of abdominal pain, nausea, and fever. The leukocyte was 12590/mm3. On ultrasonography, the diameter of the appendix was 14 mmRight hemicolectomy+omentectomy+mesenteric lymph node dissection was performed for the patient who was thought to have appendix tumor. Acute and chronic inflammatory infiltration and a small number of granuloma structures were observed in the sections prepared from the appendix, whose wall was thickened, lumen enlarged and necrotic. The case reported as “granulomatous appendicitis” did not receive any treatment other than surgical resection, and the patient, who was followed up for five years, had no additional complaints. 5-10% of granulomatous appendicitis is due to Crohn's disease. Other causes of granulomatous inflammation of the appendix include yersinia infection, tuberculosis, sarcoidosis, intermittent appendicitis, foreign body reaction, fecal obstruction, diverticulitis, mucocele, and tumor. Patients diagnosed with granulomatous appendicitis should be investigated for the causes of granulomatous appendicitis and should be followed up for a long time, especially in terms of Crohn's disease.

Key words: Appendix, granulomatous appendicitis, crohn's disease