BACKGROUND & AIMS: Appendectomy is associated with a low risk of subsequent ulcerative colitis. This study analyzes the risk of Crohn's disease after appendectomy. METHODS: We followed-up 212,218 patients with appendectomy before age 50 years and a cohort of matched controls, identified from the Swedish Inpatient Register and the nationwide Census, for any subsequent diagnosis of Crohn's disease. RESULTS: An increased risk of Crohn's disease was found for more than 20 years after appendectomy, with incidence rate ratio 2.11 (95% confidence interval [CI], 1.21-3.79) after perforated appendicitis, 1.85 (95% CI, 1.10-3.18) after nonspecific abdominal pain, 2.15 (95% CI, 1.25-3.80) after mesenteric lymphadenitis, 2.52 (95% CI, 1.43-4.63) after other diagnoses. After nonperforated appendicitis, there was an increased risk among women but not among men (incidence rate ratio 1.37; 95% CI, 1.03-1.85, respectively, 0.89, 95% CI, 0.64-1.24). Patients operated on before age 10 years had a low risk (incidence rate ratio 0.48, 95% CI, 0.23-0.97). Crohn's disease patients with a history of perforated appendicitis had a worse prognosis. CONCLUSIONS: Appendectomy is associated with an increased risk of Crohn's disease that is dependent on the patient's sex, age, and the diagnosis at operation. The pattern of associations suggests a biologic cause.
BACKGROUND & AIMS: Appendectomy is associated with a low risk of subsequent ulcerative colitis. This study analyzes the risk of Crohn's disease after appendectomy. METHODS: We followed-up 212,218 patients with appendectomy before age 50 years and a cohort of matched controls, identified from the Swedish Inpatient Register and the nationwide Census, for any subsequent diagnosis of Crohn's disease. RESULTS: An increased risk of Crohn's disease was found for more than 20 years after appendectomy, with incidence rate ratio 2.11 (95% confidence interval [CI], 1.21-3.79) after perforated appendicitis, 1.85 (95% CI, 1.10-3.18) after nonspecific abdominal pain, 2.15 (95% CI, 1.25-3.80) after mesenteric lymphadenitis, 2.52 (95% CI, 1.43-4.63) after other diagnoses. After nonperforated appendicitis, there was an increased risk among women but not among men (incidence rate ratio 1.37; 95% CI, 1.03-1.85, respectively, 0.89, 95% CI, 0.64-1.24). Patients operated on before age 10 years had a low risk (incidence rate ratio 0.48, 95% CI, 0.23-0.97). Crohn's diseasepatients with a history of perforated appendicitis had a worse prognosis. CONCLUSIONS: Appendectomy is associated with an increased risk of Crohn's disease that is dependent on the patient's sex, age, and the diagnosis at operation. The pattern of associations suggests a biologic cause.
Authors: E F Stange; S P L Travis; S Vermeire; C Beglinger; L Kupcinkas; K Geboes; A Barakauskiene; V Villanacci; A Von Herbay; B F Warren; C Gasche; H Tilg; Stefan W Schreiber; J Schölmerich; W Reinisch Journal: Gut Date: 2006-03 Impact factor: 23.059
Authors: Gilaad G Kaplan; Bo V Pedersen; Roland E Andersson; Bruce E Sands; Joshua Korzenik; Morten Frisch Journal: Gut Date: 2007-05-09 Impact factor: 23.059
Authors: S Baron; D Turck; C Leplat; V Merle; C Gower-Rousseau; R Marti; T Yzet; E Lerebours; J-L Dupas; S Debeugny; J-L Salomez; A Cortot; J-F Colombel Journal: Gut Date: 2005-03 Impact factor: 23.059
Authors: Ashley E Nordsletten; Henrik Larsson; James J Crowley; Catarina Almqvist; Paul Lichtenstein; David Mataix-Cols Journal: JAMA Psychiatry Date: 2016-04 Impact factor: 21.596