The Dilemma of Stump Appendicitis: A Case Report

TL;DR

This case report describes a rare complication of appendectomy called stump appendicitis, where a patient developed inflammation and perforation of the remaining appendix one year after surgery.

Contribution

The paper presents a clinical case emphasizing the need for awareness and careful surgical technique to prevent stump appendicitis.

Findings

Stump appendicitis can occur years after appendectomy and mimic other abdominal conditions.

Diagnostic delays are common due to low clinical suspicion.

Surgical excision of the inflamed stump is curative and leads to recovery.

Abstract

Stump appendicitis is an uncommon but clinically significant delayed complication of appendectomy, arising from inflammation of remnant appendiceal tissue after the initial procedure. Because most clinicians do not consider appendicitis in a post-appendectomy patient, stump appendicitis frequently results in diagnostic delay and increased morbidity.

We report the case of a 27-year-old man from a northern state of India who presented with features of generalized peritonitis one year after undergoing open appendectomy for acute appendicitis. Radiological evaluation suggested inflammation but failed to identify the specific pathology. Under exploratory laparotomy, a 3 cm, inflamed, and perforated appendiceal stump was identified and excised. The patient made an uneventful recovery.

This case highlights the importance of maintaining a high index of suspicion for stump appendicitis in patients with previous appendectomy presenting with acute abdomen and emphasizes the need for meticulous surgical technique during the primary procedure.

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