Appendectomy is followed by increased risk of Crohn's disease

Andersson, Roland (author)

Olaison, Gunnar, 1947- (author): Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Kirurgi,Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala

Tysk, Curt, 1949- (author): Linköpings universitet,Hälsouniversitetet,Gastroenterologi och hepatologi

(creator_code:org_t)

Elsevier BV, 2003
2003
English.
In: Gastroenterology. - : Elsevier BV. - 0016-5085 .- 1528-0012. ; 124:1, s. 40-46

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; http://kipublication...; show less...

Abstract Subject headings

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.

By the author/editor: Andersson, Rolan ...; Olaison, Gunnar, ...; Tysk, Curt, 1949 ...; Ekbom, Anders

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