title: Significance of appendiceal involvement in patients with ulcerative colitis.
abstract: BACKGROUND
  The appendix is occasionally involved in patients with distal ulcerative colitis. This study investigated the clinical significance of patchy involvement at the appendiceal orifice in ulcerative colitis.
  
  
  METHODS
  Colonoscopy was performed in 40 patients with active distal ulcerative colitis of mild to moderate severity. Patients were divided into 2 groups based on the presence or absence (positive or negative) of involvement at the appendiceal orifice at colonoscopy. Clinical activity, histologic grade of inflammation, and subsequent clinical course were compared between patients who were positive (appe(+)) and negative (appe(-)).
  
  
  RESULTS
  Twenty-three patients had involvement at the appendiceal orifice (reddish mucosa with mucinous exudate). The proximal-most extent of involvement by ulcerative colitis, the endoscopic grade, and clinical activity were not different between appe(+) and appe(-) groups. However, histologic grade of inflammation in the ascending colon was higher in the appe(+) group than in the appe(-) group. The endoscopic remission rate at 12 months was higher in the appe(+) group than in the appe(-) group (84% vs. 40%, p < 0.05).
  
  
  CONCLUSIONS
  In patients with distal ulcerative colitis, involvement at the appendiceal orifice may be indicative of histologically active disease, which responds reasonably well to pharmacotherapy.
authors.affiliation: Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Shotaro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Michio
authors.initials: M
authors.lastname: Shimizu
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000175:diagnosis* / Q000473:pathology; D001065:Appendix / Q000473:pathology; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged