{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:22:17Z","timestamp":1787984537302,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have indicated that the appendix may be a priming site of ulcerative colitis (UC). Appendectomy is inversely associated with the development of UC, and is suggested to have a beneficial effect on the disease course in patients with refractory disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of the current study was to assess histological features of appendices from patients with UC and their clinical relevance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with UC in remission and active UC (therapy refractory) that underwent appendectomy between 2012 and 2019 were included. Histological features of UC appendices were compared to those of patients with acute appendicitis and colon carcinoma. The Robarts Histopathology Index (RHI) was used to assess appendiceal inflammation. In patients with active UC, histological and clinical characteristics were compared between patients with and without endoscopic response following appendectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 140 appendix specimens were assessed (<jats:italic>n<\/jats:italic>\u00a0=\u00a035 UC remission, <jats:italic>n<\/jats:italic>\u00a0=\u00a035 active UC, <jats:italic>n<\/jats:italic>\u00a0=\u00a035 acute appendicitis, <jats:italic>n<\/jats:italic>\u00a0=\u00a035 colon carcinoma). Histological features of appendices from UC patients looked like UC rather than acute appendicitis. The presence of active appendiceal inflammation was comparable between patients in remission versus active disease (53.7% vs. 46.3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.45) and limited versus extensive disease (58.5% vs. 41.5%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.50). Endoscopic response (Mayo 0\u20131) following appendectomy, assessed in 28 therapy refractory patients, was more frequently seen in patients with higher RHI scores (RHI\u00a0&gt;\u00a06: 81.8% vs. RHI\u00a0\u2264\u00a06: 9.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) and limited disease (proctitis\/left sided 63.6% vs. pancolitis 36.4%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of active appendiceal inflammation is common in UC and does not correlate with colonic disease activity. More than 50% of UC patients in remission showed active histological disease in the appendix. Favorable response to appendectomy for refractory UC was seen in cases with ulcerative appendicitis. These findings might support the role of the appendix as a pivotal organ in UC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12171","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T09:47:15Z","timestamp":1636451235000},"page":"1148-1156","source":"Crossref","is-referenced-by-count":26,"title":["High prevalence of ulcerative appendicitis in patients with ulcerative colitis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6961-0996","authenticated-orcid":false,"given":"Lianne","family":"Heuthorst","sequence":"first","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Center, location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3803-1622","authenticated-orcid":false,"given":"Aart","family":"Mookhoek","sequence":"additional","affiliation":[{"name":"Institute of Pathology University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon E.","family":"Wildenberg","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research Amsterdam University Medical Center  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert R.","family":"D'Haens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam University Medical Center, location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem A.","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Center, location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne J.","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Center, location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12821"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2000.imr017516.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molimm.2012.11.010"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103153441104"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90016-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.2007.03463.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izy332"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2011.02600.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.388"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11259"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002037"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2014.08.012"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3129-z"},{"issue":"2","key":"e_1_2_8_15_1","first-page":"65","article-title":"Lymphocytes populations in appendiceal lavage fluid predictive of IBD\u2010related inflammation","volume":"9","author":"Sahami SGT","year":"2018","journal-title":"Gastroenterol Hepatol Open Access"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310393"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.1998.00477.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjz123"},{"issue":"2","key":"e_1_2_8_19_1","first-page":"151","article-title":"\"Ulcerative appendicitis\" occurring as a skip lesion in chronic ulcerative colitis; 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