Case report demonstrates effective conservative management of complicated acute appendicitis in Crohn's disease, indicating the importance of ultrasound monitoring.
According to the most recent guidelines, uncomplicated acute appendicitis could be treated conservatively using broad-spectrum antibiotics, but if radiological signs of appendix rupture are present, appendectomy should be considered as first-line treatment. There is limited evidence in literature regarding the non-operative management of complicated acute appendicitis, particularly in the subset of patients with Crohn's disease. Intestinal and contrast-enhanced ultrasound appear pivotal to both diagnosing complications and promptly identifying the non-responding patients. We describe two cases of complicated acute appendicitis, successfully treated with broad-spectrum antibiotic therapy and tight monitoring with both intestinal and contrast-enhanced ultrasound, in patients with Crohn's disease.
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Giovanni et al. (2026) studied this question.
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