Recurrent right iliac fossa pain in patients with previous appendicectomy

Recurrent appendicitis can occur up to 40 years after appendicectomy. A history of appendicectomy has often led to late diagnosis, as sepsis is attributed to other organs, usually the urinary tract. A case of a patient presenting with retained faecolith and recurrent/stump appendicitis 2 years after laparoscopic appendicectomy is presented. The case for having a low threshold for early CT scanning in patients post-appendicectomy presenting with sepsis to prevent delay in diagnosis is made, and this case is a useful reminder for surgeons to dissect as far as possible to the appendix base. The literature including important medicolegal cases is reviewed.