Role of Conservative Management in Stump Appendicitis: A Case Series

Abstract

Stump appendicitis is a rare, delayed complication of appendectomy. It is seen following both open and laparoscopic appendectomy and may occur weeks to years following the initial appendectomy. We report two cases of stump appendicitis seen at our hospital. Both cases were diagnosed based on radiological findings and successfully managed conservatively with antibiotics. Although the usually recommended treatment for stump appendicitis is completion appendectomy, conservative management may be suitable for some patients. This report highlights the possibility of utilizing a conservative approach in the management of stump appendicitis compared to the recommended operative intervention. Awareness of the possibility of stump appendicitis is crucial for early diagnosis and treatment, to prevent potentially catastrophic complications.

Keywords: appendectomy; appendicitis; case reports..

Figure 1. CECT (Contrast Enhanced Computed Tomography) in sagittal view showing blind-ending tubular structure arising from the caecal pole with adjacent fat stranding.

Figure 2. CECT axial view showing a tubular structure (10 mm in diameter) extending from the base of the caecum with thickened and enhancing walls, stranding of the adjacent fat.

Figure 3. CECT coronal view showing periapical inflammatory change, as well as caecal wall thickening.

Figure 4. CECT coronal view showing a tip of the remnant appendix tissue arising from the caecal wall.

Figure 5. CECT sagittal view showing air foci within the tubular structure with minimal surrounding fat stranding.