Stump Appendicitis: A case report

What is it?

Stump appendicitis is a rare complication following appendicectomy. It has an incidence of one in 50,000 cases. It is caused by inflammation of the residual appendicular tissue after appendicectomy.

Paying attention to the possibility of stump appendicitis in a patient with right lower abdominal pain with past history of appendicectomy, can prevent the delay of diagnosis and treatment. The imaging modality of choice for this condition is CECT scan of whole abdomen. CECT scan is not only assists in making an accurate preoperative diagnosis but it also excludes other etiologies. All patients with stump appendicitis need to have laparoscopic or open stump appendicectomy performed as soon as possible. Any delay will only increase the risk of rupture of the appendiceal remnant if it has not already occurred.

Case report:

Dr Susenjit Prasad Mahato have done one such stump appendicectomy by laparoscopic surgery in Kolkata. One gentleman of 35 years old presented with pain right lower abdomen with history of open appendicectomy 1year ago. CECT of abdomen was done which revealed findings “suspicious for stump appendicitis”.

The patient was admitted and given i.v. antibiotics an scheduled for surgery. Laparoscopic exploration confirmed stump appendicitis. The inflamed appendiceal stump was found approx. 1.5×3.5 cm. The entire appendiceal remnant was removed. The patient recovered well following the surgery and was discharged home on postoperative day two.

Inference:

Stump Appendicitis is a rare and dangerous complication post-appendicectomy. Being unfamiliar with this entity, it can be tough to diagnose it. This blog post is aimed to raise awareness for it as a differential diagnosis for right lower quadrant abdominal pain in any patient, despite a prior history of appendicectomy.

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