Is Appendectomy a Risk Factor for Crohn’s Disease Onset or Development in the Western Algerian Population?

Abstract

Background: Crohn’s disease is characterized by damage to the intestines, which can affect the gastrointestinal tract (from the mouth to the anus). The risks of Crohn’s disease appear to be linked to changes in the gut Macrobiota or disturbances in the mucosa and intestinal genetics. Objectives: We aimed to study the implication of appendectomy on the risk of the development of Crohn’s disease in the western Algeria population. Methods: It was a retrospective analytical study of 403 patients from 2007 to 2020 carried out at the level of general surgery departments and university hospitals in western Algeria. Results: Four hundred three CD patients were included in our study. Among them, 81 cases have undergone an appendectomy. The average age was 36.88 ± 12.47, and the most affected location was the ileocecal location with P = 0.001. However, no significant association was noted between appendectomy and CD phenotype. Most of them suffered from constipation (P < 0.0001), came from urban areas, and presented extra-intestinal manifestations (P < 0.0001). Treatment of the disease was often medical, while 68 cases of the 81 appendectomized patients underwent surgery. Early relapse of CD was also observed in appendectomized patients with P = 0.035. Moreover, many complications (anal fissures, anal fistula) were also noted but with no significant association. Conclusions: From our results, it appears that Crohn’s disease risk can be associated with a previous appendectomy and mainly manifested by ileocecal localization and constipation.