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. 2015:14:101-3.
doi: 10.1016/j.ijscr.2015.07.017. Epub 2015 Jul 26.

The dilemma of stump appendicitis - A case report and literature review

Rasika Hendahewa  1 , Ashvini Shekhar  2 , Sujith Ratnayake  1
Affiliations

The dilemma of stump appendicitis - A case report and literature review

Rasika Hendahewa et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Stump appendicitis is one of the rare delayed complications post appendectomy with a reported incidence of 1 in 50,000 cases. Stump appendicitis can present as a diagnostic dilemma if the treating clinician is unfamiliar with this rare clinical entity. A PubMed search was conducted to identify cases of stump appendicitis following appendectomy. Sixty one cases of SA that were reported in English medical literature were analyzed.

Presentation of case: We report a case of stump appendicitis (SA) with a systematic review and challenges encountered during the management.

Discussion: The interval from original appendectomy to stump appendicitis ranged from 4 days to 50 years. SA followed appendectomy in 58% of open and 31.6% of laparoscopic procedures. SA was frequently misdiagnosed as constipation, gastroenteritis or right sided diverticulitis, therefore leading to a significant delay to surgery. Computerized Tomography diagnosed SA in 56.3% of cases. Perforation with gangrene of the stump occurred in 60%.

Conclusion: Stump appendicitis can represent a diagnostic dilemma if the treating physician is unfamiliar with this uncommon clinical entity. Radiological imaging is required to aid diagnosis and a completion appendectomy is the modality of treatment.

Keywords: Appendectomy; Appendicectomy; Completion appendectomy; Stump appendicitis.

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Figures

Fig. 1
Fig. 1
Arrow indicating appendiceal stump with inflammatory changes.
Fig. 2
Fig. 2
Coronal view with arrow indicating features of stump appendicitis.
Fig. 3
Fig. 3
Gas locules along the caecal pole.
See this image and copyright information in PMC

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