A 56-year-old woman presented with signs and symptoms of appendicitis. She was taken to the operating room and explored through a right lower quadrant incision. The appendix was normal. The incision was extended and the terminal ileum was eviscerated to look for a Meckle’s diverticulum. There was no Meckels, but the terminal ileum was inflamed and thickened. The right colon and ileum are shown.
The extent of ileal involvement is shown. The appendix was removed and the bowel returned to the abdominal cavity. Terminal ileitis as a presenting form of Crohn’s (see Crohn’s discussion) often resolves without chronic recurrences. If the base of the cecum is not clinically inflamed, the appendix should be removed.
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