Stump appendicitis: A review

Kanona, Hala; Samaraee, Ahmad Al; Nice, Colin; Bhattacharya, Vish

doi:10.1016/j.ijsu.2012.07.007

Cited by 50 publications

(61 citation statements)

References 37 publications

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“…Literature on stump leakage and stump appendicitis is limited, and no exact incidences have been reported in the literature, although it is assumed that it is more common in patients with complicated appendicitis and after OA [176]. A recommendation to avoid stump leakage or stump appendicitis is to resect the appendix as a whole [176].…”

Section: Post-operative Complicationsmentioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

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Section: Post-operative Complicationsmentioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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“…This has often been associated with difficult appendicectomies with significant local inflammation or complications such as perforation or phlegmon 2 3. At laparoscopy, the appendiceal critical view should be obtained, with the appendix held at 10 o’clock, taenia coli at 3 o’clock and terminal ileum at 6 o’clock, with a clear view of the termination of the taenia at the base of the appendix.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of this condition has generally been through operation, with resection, either open or laparoscopic, of the appendiceal stump 2. Depending on the degree of inflammation and difficulty of the operation, distal caecectomy and even right hemicolectomy may be required.…”

Section: Discussionmentioning

confidence: 99%

“…It is unclear if conservative management, followed by interval appendicectomy may be a useful treatment strategy. Invagination of the appendiceal stump and routine stapling of the base of the appendix have been suggested to reduce this complication; however, currently no literature support this hypothesis 2 3Learning points

Stump appendicitis is rare but should be considered in patients presenting with symptoms and signs similar to acute appendicitis and a history of previous appendicectomy.

Care should be taken to identify the appendiceal base at operation.

…”

Section: Discussionmentioning

confidence: 99%

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Stump appendicitis 5 years after laparoscopic appendicectomy

et al. 2016

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A 31-year-old healthy man presented with right lower quadrant pain and tenderness, mild neutrophilia and clinical presentation consistent with appendicitis, despite undergoing a laparoscopic appendicectomy 5 years prior. CT scan demonstrated a caecal phlegmon, in the expected region of the appendiceal stump. The patient was taken for laparoscopy and a 2 cm inflamed appendiceal stump was encountered. A distal caecectomy was performed and the patient made an unremarkable recovery. Histological examination was consistent with acute inflammation of the appendiceal stump. Only a small number of case reports of stump appendicitis have been published so far. Correct identification and ligation of the appendiceal stump is crucial to prevent this complication. Although normally it is treated with completion appendicectomy, the optimal treatment approach for this condition has not been well established.

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“…26 Patients with previous appendectomies may uncommonly present with inflammatory changes surrounding residual appendiceal tissue, also known as stump appendicitis. 27 …”

Section: Acute Appendicitismentioning

confidence: 99%