A Pediatric Case of Granulomatous Appendicitis Operated Due to Recurrent Abdominal Pain.

Abstract

Granulomatous appendicitis (GA) is granulomatous inflammation of the appendix wall. It is generally idiopathic; however, it may also be associated with many diseases such as Crohn's disease, parasitic infections, tuberculosis, or foreign bodies. An 11-year-old male patient, with a 3-month history of abdominal pain and bilious vomiting, had right lower quadrant abdominal tenderness. His white blood cell count was 8.6 x10³/µL. An abdomen ultrasound was considered to show plastron appendicitis and an appendectomy was performed. Microscopically, thickening of the appendix wall with edema, fibrosis and lymphoid infiltration was observed. The patient was evaluated as idiopathic GA since no disease was detected that caused GA. When the appendix has a firm consistency and is difficult to separate from the surrounding tissues, GA should be considered before malignancy, particularly in the pediatric age group. An appendectomy should be performed before deciding on radical surgery.