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Crohn’s disease (CD) is a chronic transmural inflammation of any part of the alimentary tract, especially the distal ileum and the proximal large bowel. CD is diagnosed through history, diagnostic images, and pathological findings. 1 The differential diagnoses of CD are numerous, and they include inflammatory, neoplastic, and infectious disease. 1, 2 Owing to protean presentations of CD, CD could be misdiagnosed as appendicitis.

A 19-year-old male presented to a tertiary hospital with dull abdominal pain and rebound tenderness in the right lower quadrant (RLQ) area. He had watery diarrhea and weight loss of approximately 10 kg for 2 months. Computed tomography of the abdomen showed an enlarged appendix and mural enhancement of the terminal ileum (Fig. 1A). Laparoscopic appendectomy was performed because of presumptively ruptured appendicitis. After the appendectomy, the patient had recurrent spiking fevers and bloody stools for 15 days; therefore, he was transferred to our hospital. Pale conjunctivae and abdominal tenderness in the RLQ region, without peritoneal signs, were observed. Owing to persistent