Review paper
Surgical treatment of ileocaecal Leśniowski-Crohn’s disease diagnosed during appendectomy

Treatment of the Leśniowski-Crohn’s disease is still a big challenge for many specialist doctors including surgeons. In this paper surgical treatment of the patients with Leśniowski--Crohn’s disease, localized in ileocaecal region with the first symptom as acute pain in the right hypogastrium suggesting appendicitis was discussed. Leśniowski-Crohn’s disease limited to the appendix is a rare form of this disease diagnosed only in a few percent of all patients. The diagnosis is established usually based on histopathological examination of the resected appendix. Patients, who suffer from this kind of the Leśniowski-Crohn’s disease have good prognosis. Appendectomy performed as the first stage should be considered as the only necessary method of treatment. Much more common problem is appendicitis accompanied by typical inflammation localized in the ileocaecal region. It is known that a few percent of patients with Leśniowski-Crohn’s disease is diagnosed during operation performed because of the symptoms suggesting appendicitis. In such cases, ileocaecal resection should be considered as correct therapeutic management. According to bowel sparing surgery methods resection should be performed without any margin of healthy bowel. The method of anastomosis, which is important from a surgical point of view seems not to be of great importance.