Complicated Acute Appendicitis Conservatively Treated in Two Patients With Crohn's Disease: The Role of Intestinal Ultrasound and Contrast-Enhanced Ultrasound.

According to the most recent guidelines, uncomplicated acute appendicitis could be treated conservatively using broad-spectrum antibiotics, but if radiological signs of appendix rupture are present, appendectomy should be considered as first-line treatment. There is limited evidence in literature regarding the non-operative management of complicated acute appendicitis, particularly in the subset of patients with Crohn's disease. Intestinal and contrast-enhanced ultrasound appear pivotal to both diagnosing complications and promptly identifying the non-responding patients. We describe two cases of complicated acute appendicitis, successfully treated with broad-spectrum antibiotic therapy and tight monitoring with both intestinal and contrast-enhanced ultrasound, in patients with Crohn's disease.