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APPENDECTOMY IS FOLLOWED BY INCREASED RISK OF CROHN'S DISEASE

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  • Sarah Krein
    APPENDECTOMY IS FOLLOWED BY INCREASED RISK OF CROHN S DISEASE Background & Aims: Appendectomy is associated with a low risk of subsequent ulcerative colitis.
    Message 1 of 1 , Jan 4, 2003
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      APPENDECTOMY IS FOLLOWED BY INCREASED RISK OF CROHN'S DISEASE

      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.
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