Wang WQ, Yang JP, Dong JW, Chen YB. Misdiagnosis of Crohn’s disease as appendicitis: A case report. World J Gastrointest Surg 2025; 17(9): 108348 [DOI: 10.4240/wjgs.v17.i9.108348]
Corresponding Author of This Article
Ya-Bo Chen, MD, Department of Ultrasound in Medicine, Ningbo No. 6 Hospital, No. 1059 Zhongshan East Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. chenyabo2024@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen-Qian Wang, Department of Ultrasound in Medicine, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China
Jin-Peng Yang, Jia-Wen Dong, Department of Ultrasound in Medicine, Nanxun People's Hospital, Nanxun 313009, Zhejiang Province, China
Ya-Bo Chen, Department of Ultrasound in Medicine, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang Province, China
Co-first authors: Wen-Qian Wang and Jin-Peng Yang.
Co-corresponding authors: Jia-Wen Dong and Ya-Bo Chen.
Author contributions: Wang WQ, Yang JP contributed to manuscript writing and editing and data collection. Both Dong JW and Chen YB contributed to conceptualization and supervision of the manuscript as the co-corresponding authors; All authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Bo Chen, MD, Department of Ultrasound in Medicine, Ningbo No. 6 Hospital, No. 1059 Zhongshan East Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. chenyabo2024@163.com
Received: April 18, 2025 Revised: May 23, 2025 Accepted: July 21, 2025 Published online: September 27, 2025 Processing time: 158 Days and 23.4 Hours
Abstract
BACKGROUND
Crohn’s disease (CD) is a chronic inflammatory disease of the intestinal tract that can alternate between disease phases and remission. Currently, endoscopy is the gold standard for diagnosis of CD and evaluation of its activity and complications. However, gastrointestinal ultrasound (GIUS) is a valuable technique in the management of CD because it is noninvasive, convenient, and highly accurate, sensitive, and specific.
CASE SUMMARY
A 15-year-old female presented with recurrent right lower quadrant abdominal pain that had persisted for 2 weeks. Initial GIUS and computed tomography revealed significant edema of the appendix and ascending colon wall, thickening, and multiple lymphadenopathies of the mesentery. Clinicians suspected appendicitis involving the adjacent bowel, and laparoscopic appendectomy was performed. The pathological diagnosis was acute simple appendicitis. However, the patient’s symptoms persisted and aggravated with the occurrence of hematochezia. Follow-up GIUS revealed persistent edema of the ascending and transverse colon walls, intestinal polyps, and local luminal stenosis. CD was suspected and confirmed by endoscopy.
CONCLUSION
CD should be suspected with persistent right lower quadrant abdominal pain. GIUS is essential for initial evaluation, before the confirmatory endoscopy, to assess CD-typical signs like bowel edema and thickening.
Core Tip: Crohn’s disease (CD) is a chronic inflammatory condition that can affect any part of the gastrointestinal tract. In recent years the incidence of CD has increased. Gastrointestinal ultrasound (GIUS) features in patients with CD are specific and include segmental bowel wall thickening, mesenteric edema and thickening, and bowel stenosis. When the identifications of these features are combined with clinical symptoms, a high diagnostic accuracy can be achieved. The use of GIUS for the initial diagnosis and evaluation of disease activity and complications in patients with CD is increasingly common.
