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. 2019 Jun 11;11(1):12.
doi: 10.1186/s13089-019-0128-5.

Point-of-care ultrasound diagnosis of stump appendicitis in the emergency department

Apichaya Monsomboon  1   2 , Bret P Nelson  1 , Phillip Andrus  1 , James W Tsung  3
Affiliations

Point-of-care ultrasound diagnosis of stump appendicitis in the emergency department

Apichaya Monsomboon et al. Ultrasound J. .

Abstract

Background: Stump appendicitis (SA) is a rare entity in patients with a history of appendectomy and may result in missed or delayed diagnosis. We report a case of SA diagnosed by emergency department (ED) point-of-care ultrasound (PoCUS) in an elderly woman, thus expediting her care.

Case presentation: An elderly female patient with a history of appendectomy 27 years ago was referred by her physician to the ED with right lower quadrant pain for 2 days. Using PoCUS the emergency physician identified SA. This was confirmed by computed tomography (CT) scan. The patient was then successfully managed non-operatively using antibiotics.

Conclusions: Despite its rarity, it is feasible to diagnose SA using PoCUS, as patients presenting with right lower quadrant pain and history of appendectomy are at risk for delayed diagnosis, perforation, and poor outcome. PoCUS may reduce time to diagnosis, time to definitive operative or non-operative management, and minimize morbidity.

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Conflict of interest statement

Dr. Nelson has consulted for Simulab Corp. Dr. Tsung was an educational consultant to G.E. Healthcare Point-of-care Ultrasound Division in 2017. Drs. Monsomboon and Andrus have no financial relationships or competing interest to report.

Figures

Fig. 1
Fig. 1
a Transverse (short axis) ultrasound scan shows SA measuring 9.4 mm in diameter. b Longitudinal ultrasound scan shows tubular blind-ended structure with surrounding with free fluid
Fig. 2
Fig. 2
CT scan shows thickening and inflammatory change of a tubular structure extending from the base of the cecum, surrounding with inflammatory change
See this image and copyright information in PMC

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References

    1. Liang MK, Lo HG, Marks JL. Stump appendicitis: a comprehensive review of literature. Am Surg. 2006;72:162–166. - PubMed
    1. Leff DR, Sait MR, Hanief M, Salakianathan S, Darzi AW, Vashisht R. Inflammation of the residual appendix stump: a systematic review. Colorectal Dis. 2012;14:282–293. doi: 10.1111/j.1463-1318.2010.02487.x. - DOI - PubMed
    1. Rose TF. Recurrent appendiceal abscess. Med J Aust. 1945;1(26):659–662.
    1. Harris CR. Appendiceal stump abscess ten years after appendectomy. Am J Emerg Med. 1989;7:411–412. doi: 10.1016/0735-6757(89)90050-8. - DOI - PubMed
    1. Subramanian A, Liang MK. A 60-year literature review of stump appendicitis: the need for a critical view. Am J Surg. 2012;203(4):503–507. doi: 10.1016/j.amjsurg.2011.04.009. - DOI - PubMed

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