Peri-appendiceal inflammation is associated with appendiceal orifice stenosis and appendiceal body thickening in ulcerative colitis: A case-control study.

ObjectiveThis case-control study aimed to investigate whether peri-appendiceal inflammation is associated with orifice stenosis and appendiceal body thickening in patients with ulcerative colitis.MethodsData from patients with ulcerative colitis-including demographics, symptoms, medications, clinical signs, diagnosis, laboratory tests, colonoscopy findings, and abdominal computed tomography-were recorded and analyzed. Orifice stenosis was defined as apparent narrowing or disappearance of the appendiceal orifice compared with the nearest cecal fold. A thickened appendiceal body was defined as an appendiceal >6 mm with or without surrounding inflammatory changes on computed tomography. The severity of peri-appendiceal inflammation was scored using the Mayo endoscopic score.ResultsA total of 169 patients with ulcerative colitis were included, of whom 17.2% (29/169) had appendiceal orifice stenosis. Appendiceal orifice stenosis was associated with age (odds ratio: 1.042, P = 0.008) and the peri-appendiceal inflammation score (odds ratio: 3.382, P < 0.001). Among 42 patients who underwent abdominal computed tomography, 69.0% (29/42) had appendiceal body thickening. None of these 29 patients had a positive McBurney sign or a flare of acute appendicitis. Appendiceal width was associated with the peri-appendiceal inflammation score (odds ratio: 4.172, P = 0.006).ConclusionsAppendiceal orifice stenosis and appendiceal body thickening are prevalent in patients with ulcerative colitis. Peri-appendiceal inflammation is associated with the severity of stenosis and appendiceal width, suggesting it may serve as an indirect indicator of appendiceal inflammation related to ulcerative colitis.