{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:36:29Z","timestamp":1762353389212,"version":"3.41.2"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The coexistence of Crohn's disease (CD) and acute appendicitis (AA) is rare. In this situation, therapeutic experience is lacking and the strategy is paradoxical and intractable. Appendectomy is the gold standard for the treatment of AA whereas a nonsurgical approach is recommended for CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case summary<\/jats:title><jats:p>A 17-year-old boy was hospitalized for right lower abdominal pain with fever of 3 days. He had the CD for 8 years. Two years ago, he underwent surgery for anal fistula with the complication of CD. His temperature was elevated at 38.3\u00b0C at admission. On physical examination, there was McBurney tenderness with mild rebound tenderness. Abdominal ultrasonography showed that the appendix was notably enlarged and dilated at 6.34 cm long and 2.76 cm wide. These findings were suggestive of uncomplicated AA in this patient with active CD. Endoscopic retrograde appendicitis therapy (ERAT) was performed. The patient had complete pain relief immediately after the procedure without tenderness in the right lower abdomen. During 18 mo follow-up, he had no more attacks in his right lower abdomen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ERAT was effective and safe in a CD patient with coexisting AA. Such cases can avoid surgery and its-related complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1171463","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T05:05:45Z","timestamp":1686287145000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["First human case report of Crohn's disease with coexistent acute appendicitis treated by endoscopic retrograde appendicitis therapy"],"prefix":"10.3389","volume":"10","author":[{"given":"Guang-xing","family":"Cui","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Zulqarnain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi-feng","family":"Lou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-zhang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haitao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamse","family":"Mohamoud Abdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingfei","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shijie","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangzhou","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqian","family":"Ling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linglin","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saboor","family":"Saeed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines","volume":"15","author":"Di Saverio","year":"2020","journal-title":"World J Emerg Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"4668","DOI":"10.1007\/s00464-016-5245-7","article-title":"Diagnosis and management of acute appendicitis","volume":"30","author":"Gorter","year":"2016","journal-title":"EAES consensus development conference 2015. Surg Endosc."},{"key":"B3","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1007\/s00464-009-0678-x","article-title":"Laparoscopic appendectomy is the preferred approach for appendicitis: a retrospective review of two practice patterns","volume":"24","author":"Nakhamiyayev","year":"2010","journal-title":"Surg Endosc."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1097\/SLA.0000000000003225","article-title":"Antibiotic treatment and appendectomy for uncomplicated acute appendicitis in adults and children: a systematic review and meta-analysis","volume":"270","author":"Podda","year":"2019","journal-title":"Ann Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1002\/bjs.10147","article-title":"Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis","volume":"103","author":"Sallinen","year":"2016","journal-title":"Br J Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1093\/ecco-jcc\/jjaa043","article-title":"ECCO guidelines on therapeutics in crohn's disease: medical treatment","volume":"14","author":"Torres","year":"2020","journal-title":"J Crohns Colitis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1093\/ecco-jcc\/jjz187","article-title":"ECCO guidelines on therapeutics in crohn's disease: surgical treatment","volume":"14","author":"Adamina","year":"2020","journal-title":"J Crohns Colitis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1007\/BF02554158","article-title":"Acute suppurative appendicitis. A rare associate of Crohn's disease","volume":"28","author":"Rawlinson","year":"1985","journal-title":"Dis Colon Rectum."},{"key":"B9","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1097\/00004836-199212000-00008","article-title":"Preoperative clues to Crohn's disease in suspected, acute appendicitis. Report of 12 cases and review of the literature","volume":"15","author":"Oren","year":"1992","journal-title":"J Clin Gastroenterol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/j.gie.2012.05.029","article-title":"Endoscopic retrograde appendicitis therapy: a pilot minimally invasive technique (with videos) gastrointest endosc","volume":"76","author":"Liu","year":"2012"},{"key":"B11","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1002\/ibd.20558","article-title":"Long-term health outcomes in pediatric inflammatory bowel disease: a population-based study","volume":"15","author":"Turunen","year":"2009","journal-title":"Inflamm Bowel Dis."},{"key":"B12","first-page":"113","article-title":"Crohn's disease of the appendix","volume":"107","author":"Ruiz","year":"1990","journal-title":"Surgery."},{"key":"B13","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1001\/archsurg.1982.01380250003001","article-title":"Management of the appendix in young patients with Crohn's disease","volume":"117","author":"Fonkalsrud","year":"1982","journal-title":"Arch Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"E1014","DOI":"10.1055\/a-1819-8231","article-title":"Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis","volume":"10","author":"Dhindsa","year":"2022","journal-title":"Endosc Int Open."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2480","DOI":"10.1007\/s00464-021-08533-8","article-title":"Endoscopic retrograde appendicitis therapy for management of acute appendicitis","volume":"36","author":"Ding","year":"2022","journal-title":"Surg Endosc."},{"key":"B16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12876-022-02139-7","article-title":"Endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy versus open appendectomy for acute appendicitis: a pilot study","volume":"22","author":"Shen","year":"2022","journal-title":"BMC Gastroenterol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1055\/s-0032-1313348","article-title":"Pediatric crohn disease presenting as appendicitis: differentiating features from typical appendicitis","volume":"22","author":"Bass","year":"2012","journal-title":"Eur J Pediatr Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"3285","DOI":"10.1007\/s10620-016-4245-8","article-title":"Diagnosis of acute appendicitis by endoscopic retrograde appendicitis therapy (ERAT): combination of colonoscopy and endoscopic retrograde appendicography","volume":"61","author":"Li","year":"2016","journal-title":"Dig Dis Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1053\/j.gastro.2021.09.032","article-title":"Missing plastic stent, an unreported complication of endoscopic retrograde appendicitis therapy","volume":"162","author":"Li","year":"2022","journal-title":"Gastroenterology."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1171463\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T05:05:48Z","timestamp":1686287148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1171463\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,9]]},"references-count":19,"alternative-id":["10.3389\/fmed.2023.1171463"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1171463","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2023,6,9]]},"article-number":"1171463"}}