title: Periappendiceal inflammation in pediatric ulcerative colitis.
abstract: BACKGROUND
  An involvement of the appendiceal orifice as a distintive skip lesion in adults with left side ulcerative colitis (UC) has been reported. The aim of our prospective study was to evaluate, by endoscopy and histology, the prevalence of periappendiceal inflammation (PAI) in children affected by UC.
  
  
  METHODS
  Fifty of 77 consecutive children undergoing total colonoscopy, who had a diagnosis of UC not extended beyond the hepatic flexure were enrolled.
  
  
  RESULTS
  PAI was endoscopically present in 16 of 50 patients (32%) with UC. Patients were divided in 2 groups: group A included the 16 patients with PAI, whereas group B included 34 patients without PAI. We found that among the 2 groups, PAI was more frequent in patients with new diagnosis than in those with pre-existing UC (P = 0.016). At index colonoscopy, the patients of group A had a significant major extent of disease (P = 0.013). Moreover, the histologic grade of inflammation at the ascending colon was significantly higher in group A than in group B (P = 0.014). Clinical activity, measured by pediatric ulcerative colitis activity index, and use of medication did not show significant differences among groups (P = 0.464 and P = 0.723, respectively). The use of immunosuppressant was significantly higher in group A than in group B.
  
  
  CONCLUSIONS
  PAI is a frequent skip lesion in children with UC. It seems more frequent in patients with new diagnosis, and it is associated with a major extent of the disease and with a higher grade of histologic inflammation at the ascending colon.
authors.affiliation: Department of Pediatrics, University of Naples "Federico II", Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Strisciuglio
authors.forename: Eleonora
authors.initials: E
authors.lastname: Giannetti
authors.forename: Francesca Paola
authors.initials: FP
authors.lastname: Giugliano
authors.forename: Luigi
authors.initials: L
authors.lastname: Greco
authors.forename: Severo
authors.initials: S
authors.lastname: Campione
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: D' Armiento
authors.forename: Annamaria
authors.initials: A
authors.lastname: Staiano
authors.forename: Erasmo
authors.initials: E
authors.lastname: Miele
mesh_terms: D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications* / Q000628:therapy; D003113:Colonoscopy; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult