Stump Appendicitis

Stump appendicitis is a delayed complication of appendectomy. Patients present with symptoms similar to an initial presentation for appendicitis. Diagnosis is often delayed as history of appendectomy often precludes focused workup for an appendiceal source of infection. A 39-year-old female presented to our emergency department with worsening abdominal pain and fever. Se had a past surgical history of a laparoscopic appendectomy approximately 14 months prior to presentation. During her admission, she was diagnosed with ruptured stump appendicitis by computerized tomography (CT) imaging. A percutaneous drain was placed and the patient was discharged with antibiotics. Follow up evaluation revealed clinical improvement, with resolution of peri-appendiceal stump inflammation and subsequent percutaneous drain removal. Completion appendectomy is tentatively scheduled. This case highlights awareness of stump appendicitis as a differential diagnosis for patients with previous appendectomy who present with acute abdominal pain.