Case report
https://doi.org/10.5281/zenodo.3517770
Stump appendicitis after laparoscopic appendectomy: a rare clinical entity
Asmir Jonuzi
orcid.org/0000-0002-5637-9510
; Clinic of Pediatric surgery, Clinical Center University of Sarajevo, Bosnia and Herzegovina
Nusret Popović
; Clinic of Pediatric surgery, Clinical Center University of Sarajevo, Bosnia and Herzegovina
Zlatan Zviždić
orcid.org/0000-0003-1238-880X
; Clinic of Pediatric surgery, Clinical Center University of Sarajevo, Bosnia and Herzegovina
Emir Milišić
; Clinic of Pediatric surgery, Clinical Center University of Sarajevo, Bosnia and Herzegovina
Abstract
Background: Stump appendicitis is an acute inflammation of the residual part of the appendix and a rare complication of incomplete appendectomy. This is a rare delayed complication after appendectomy with the reported incidence of 1 in 50,000 cases. Clinically it can be presented as acute abdomen and presents a diagnostic dilemma. Prompt recognition is important to lead to an early treatment, thus avoiding serious complications.
Case study: We present a 14-year-old girl with diagnosis of stump appendicitis, who underwent surgical treatment (open appendectomy) after having laparoscopic appendectomy a month before. Radiologically (UZV and CT scan) was diagnosed an inflammatory mass with abscess dimension 41 x 21 mm in the right iliac fossa. During operation a 1,5 cm-diameter appendiceal stump was noted in the anatomical region of the appendix. The appendiceal stump was resected and inverted into the cecal wall. Histopathology examination showed acute inflammation and patchy necrosis of the appendiceal stump. The post-operative course was uneventful. Patient was discharged on third post-operative day.
Conclusion: Stump appendicitis is a rare but serious complication of appendectomy. The prevalence and incidence of stump appendicitis has been increasing in the recent years. Clinical presentation of stump appendicitis mimics symptoms and signs of acute appendicitis or acute abdomen and with a previous appendectomy. So it must be considered in the differential diagnosis of acute abdomen despite the patient’s open or especially laparoscopic appendectomy history.
Keywords
open appendectomy; stump appendicitis; acute abdomen
Hrčak ID:
228782
URI
Publication date:
3.11.2019.
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