liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Appendicitis, mesenteric lymphadenitis, and subsequent risk of ulcerative colitis: cohort studies in Sweden and Denmark
Statens Serum Institute, Denmark.
Statens Serum Institute, Denmark.
Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences.
2009 (English)In: BRITISH MEDICAL JOURNAL, ISSN 0959-8146 , Vol. 338, no b716Article in journal (Refereed) Published
Abstract [en]

Objective To determine whether the repeatedly observed low risk of ulcerative colitis after appendicectomy is related to the appendicectomy itself or the underlying morbidity, notably appendicitis or mesenteric lymphadenitis.

Design Nationwide cohort studies.

Setting Sweden and Denmark.

Participants 709 353 Swedish (1964-2004) and Danish (1977-2004) patients who had undergone appendicectomy were followed up for subsequent ulcerative colitis. The impact of appendicectomy on risk was also studied in 224 483 people whose parents or siblings had inflammatory bowel disease.

Main outcome measures Standardised incidence ratios and rate ratios as measures of relative risk.

Results During 11.1 million years of follow-up in the appendicectomy cohort, 1192 patients developed ulcerative colitis (10.8 per 100 000 person years). Appendicectomy without underlying inflammation was not associated with reduced risk (standardised incidence ratio 1.04, 95% confidence interval 0.95 to 1.15). Before the age of 20, however, appendicectomy for appendicitis (0.45, 0.39 to 0.53) or mesenteric lymphadenitis (0.65, 0.46 to 0.90) was associated with significant risk reduction. A similar pattern was seen in those with affected relatives, whose overall risk of ulcerative colitis was clearly higher than the background risk (1404 observed v 446 expected; standardised incidence ratio 3.15, 2.99 to 3.32). In this cohort, appendicectomy without underlying appendicitis did not modify risk (rate ratio 1.04, 0.66 to 1.55, v no appendicectomy), while risk after appendicectomy for appendicitis was halved (0.49, 0.31 to 0.74).

Conclusions In individuals with or without a familial predisposition to inflammatory bowel disease, appendicitis and mesenteric lymphadenitis during childhood or adolescence are linked to a significantly reduced risk of ulcerative colitis in adulthood. Appendicectomy itself does not protect against ulcerative colitis.

Place, publisher, year, edition, pages
2009. Vol. 338, no b716
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-17518DOI: 10.1136/bmj.b716OAI: diva2:209914
Available from: 2009-03-27 Created: 2009-03-27 Last updated: 2009-03-27

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Andersson , Roland
By organisation
Surgery Faculty of Health Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 28 hits
ReferencesLink to record
Permanent link

Direct link