Inflammation of the residual appendix stump: a systematic review

Abstract

Stump appendicitis is rare. It may complicate open or laparoscopic appendicectomy. A high level of suspicion should be maintained in any patient with right sided abdominal pain and a history of prior appendicectomy.

Stumped? It could be stump appendicitis

“…15 Suspicion of the condition and prompt diagnosis can potentially reduce the risk of serious complications because of delayed treatment (perforation, abscess formation), or misdiagnosis (constipation, gastroenteritis). 10 The short interval between surgery and ultrasound in the two cases we have described suggests that the findings were likely from persistent inflammation from the initial appendicitis rather than to new inflammation of the appendiceal stump. Whilst the diagnosis in our second case was confirmed surgically, the first resolved after conservative management.…”

“…Inflammation of the base or stump of a surgically removed appendix is an uncommon, and likely under‐recognised condition in both children and adults with cases reported in patients aged between 8 and 72 years of age . The paucity of documented cases in the literature make it difficult to determine its incidence, although it is estimated to occur in 1:50 000 appendicectomy patients .…”

“…True de novo cases of stump appendicitis occur once tissue granulation is complete, usually after eight weeks, and have been documented up to 50 years post‐appendicectomy . Suspicion of the condition and prompt diagnosis can potentially reduce the risk of serious complications because of delayed treatment (perforation, abscess formation), or misdiagnosis (constipation, gastroenteritis) …”

Appendiceal stump abscess-5 months after appendisectomy- A Case Report

“…However, the most recent comprehensive review of the literature examining thirty-six (36) cases of stump appendicitis by Liang et al 3 revealed that only 34% of cases were initially performed laparoscopically, and 66% were initially performed as open surgeries, thereby, supporting that it can occur after ei ther laparoscopic or open appendectomy. 19 Stump appendicitis is a real entity not often considered when evaluating patients with ri ght lower quadrant abdominal pain after appendectomy and may be probably an underreported problem. 20,21 It can occur from about two weeks to an interval of twenty-three year after appendectomy but our case presented four and half months postlaparoscopic appendicectomy.…”

Stump Appendicitis: An Uncompleted Surgery, a Rare but Important Entity with Potential Problems

“…However, the most recent comprehensive review of the literature examining thirty-six (36) cases of stump appendicitis by Liang et al [3] revealed that only 34% of cases were initially performed laparoscopically, and 66% were initially performed as open surgeries, thereby, supporting that it can occur after either laparoscopic or open appendectomy [19]. …”