title: [Isolated Crohn's disease of the appendix as a source of enterorrhagia].
abstract: BACKGROUND
  Crohn's disease confined to the appendix is relatively rare as a sole primary manifestation of the disease. Young people are more affected. The medical history and the physical examination are similar to the findings in acute appendicitis, but the manifestations are protracted. On physical examination there are signs of peritoneal irritation and an abdominal mass is palpable in the right iliac fossa.
  
  
  OBJECTIVE
  To report a case of Crohn's disease confined to the appendix and presenting with enterorrhagia. The source of the bleeding was localized by colonoscopy.
  
  
  METHODS
  A 16-year old caucasian male without past history of gastrointestinal symptoms, presented with two episodes of enterorrhagia within a period of one year. In the second episode colonoscopy identified the appendicular ostium as the source of bleeding.
  
  
  RESULTS
  At operation the cecum and terminal ileum were normal in thickness and texture, and an inflammatory appendix adherent to the omentum was removed. Microscopically there were non-caseating granulomas, intense infiltration of the wall with plasma cells, lymphocytes and macrophages. The patient has not suffered recurrence, and a colonoscopy realized 2 years after the operation did not show signs of Crohn's disease.
  
  
  CONCLUSIONS
  This case, like others in the literature, appendectomy is curative, but a 5-year follow-up is mandatory. When a young patient presents with enterorrhagia, this diagnosis has to be considered.
authors.affiliation: Hospital Samaritano, São Paulo, SP.
authors.forename: Sizenando Ernesto de
authors.initials: SE
authors.lastname: Lima
authors.forename: Manlio Basílio
authors.initials: MB
authors.lastname: Speranzini
authors.forename: Marcos Pacheco
authors.initials: MP
authors.lastname: Guiro
mesh_terms: D000293:Adolescent; D001062:Appendectomy; D001065:Appendix / Q000601:surgery; D002429:Cecal Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male