Clinical course of distal ulcerative colitis in relation to appendiceal orifice inflammation status.
BACKGROUND
Although appendiceal orifice inflammation (AOI) is frequently observed as a skip lesion of ulcerative colitis (UC), its clinical significance is not clearly understood. We aimed to evaluate whether AOI is associated with the clinical course of UC.


METHODS
Ninety-four patients with newly diagnosed distal UC were prospectively enrolled at the Asan Medical Center between March 1996 and October 2002. Clinical features and colonoscopic findings during the follow-up period were analyzed in relation to initial AOI status.


RESULTS
Forty-eight patients were found to be initially AOI-positive and 46 to be initially AOI-negative. We found no difference in the baseline demographics and clinical characteristics between these two groups. The median follow-up periods for AOI-positive and AOI-negative groups were 45 and 41 months, respectively. Clinical remission was achieved in all patients of each group. The cumulative risk of relapse at 1, 3, and 5 years after remission was 31.2%, 59.8%, and 69.2%, respectively, in the AOI-positive group and 17.4%, 46.5%, and 67.2%, respectively, in the AOI-negative group (P = 0.124). The cumulative risk of proximal disease extension at 1, 3, and 5 years after diagnosis was 17.9%, 24.9%, and 44.5%, respectively, in the AOI-positive group and 9.8%, 21.5%, and 43.9%, respectively, in the AOI-negative group (P = 0.522). Proctocolectomy was performed in no patients in the AOI-positive group and in 1 patient in the AOI-negative group. No mortalities were observed in either group.


CONCLUSIONS
In patients with distal UC, AOI may have no prognostic implications in terms of remission, relapse, or proximal disease extension.
Byeon
Jeong-Sik
JS
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Yang
Suk-Kyun
SK
Myung
Seung-Jae
SJ
Pyo
Seung Il
SI
Park
Hyun Ju
HJ
Kim
Young Min
YM
Lee
Yun Jung
YJ
Hong
Seong Soo
SS
Kim
Kyu-Jong
KJ
Lee
Gin Hyug
GH
Jung
Hwoon-Yong
HY
Hong
Weon-Seon
WS
Kim
Jin-Ho
JH
Min
Young Il
YI
D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D003113:Colonoscopy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors