Stump appendicitis 5 years after laparoscopic appendicectomy

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.