Apendicitis aguda sin enfermedad de Crohn en un paciente con inflamación intestinal: informe de un caso / Acute appendicitis without Crohn's disease in a patient with inflammatory bowel disease: case report

BACKGROUND: Crohn's disease was described for the first time in 1932. The association of acute appendicitis with this disease is very rare and when the cecum is involved, risk of fistula is very high. CASE REPORT: We present the case of a 48-year-old female who had been diagnosed with Crohn's disease several months earlier. The patient complained of intense abdominal pain in the right lower quadrant and was treated medically without improvement. Thus, laparascopic surgery was decided upon. DISCUSSION: The appendix was affected in 12-16% of all patients with Crohn's disease who had intestinal resection. CONCLUSIONS: If the cecum is not affected, appendectomy using laparascopic procedure with soft tissue drainage is adequate.

Calidad de vida después de proctocolectomía restaurativa con reservorio ileoanal en J en pacientes con colitis ulcerativa / Quality of life after restorative proctocolectomy with ileo-anal J pouch in patients with ulcerative colitis

BACKGROUND: Restorative proctocolectomy with ileal pouch-anal anastomosis has become the most common treatment in patients with ulcerative colitis. This procedure removes the entire colon, conserving the sphincteric complex and, therefore, preserving continence. The most important goal of this surgery is to improve quality of life. METHODS: We reviewed the files of patients who underwent restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis from January 1995 to December 2004 . We administered questionnaire SF-36 to evaluate quality of life. We used an observational, retrospective, and transversal method. RESULTS: Twenty J pouch procedures were done, of which files of 14 patients were reviewed. As far as quality of life, we were able to interview only eight patients and the average was as follows: physical function 75, physical status 50, corporal pain 51, general health 77, vitality 47.5, social function 62.50, emotional status 83 and mental health 74. DISCUSSION: Previous reports exist showing that proctocolectomy is a safe and effective procedure for patients with ulcerative colitis and where ileostomy is accompanied by one definitive, independent continent or pouch. CONCLUSIONS: The presence of stoma and fecal incontinence are factors that contribute to deterioration of quality of life after proctocolectomy; thus, both should be avoided. Of the patients who we interviewed, 87.5% consider that their health status has improved during 1 year.