Stump Appendicitis: Clinical and CT Findings.

Area of Science:

• Radiology
• Gastroenterology
• Surgical Pathology

Background:

• Recurrent inflammation of the appendiceal stump post-appendectomy is uncommon.
• Previous case series reported a limited number of patients.

Purpose of the Study:

• To report clinical and CT findings in a larger series of stump appendicitis cases.
• To identify predisposing factors for stump appendicitis.

Main Methods:

• Retrospective review of 14 patients diagnosed with stump appendicitis via CT.
• Analysis of clinical data and CT imaging findings by three abdominal radiologists.
• Comparison of CT findings with initial appendectomy approach and patient history.

Main Results:

• Stump appendicitis occurred a mean of 5.1 years after appendectomy (range: 5 weeks-17.5 years).
• Laparoscopic appendectomy was the initial approach in 71% of cases.
• A mean stump length of 3.2 cm was observed, with 2 cm or longer in most cases.
• Appendicoliths were present in 50% of cases.
• Extensive peris-tump inflammation and abscesses were noted on CT.
• 50% of patients required open surgery for remnant appendectomy or ileocecectomy.

Conclusions:

• Stump appendicitis exhibits characteristic CT findings.
• It can manifest shortly after appendectomy or many years later.
• Longer appendiceal stumps (≥ 2 cm), particularly after laparoscopic appendectomy, and retained appendicoliths are potential risk factors for recurrent inflammation and obstruction in adults.