Stump appendiceal abscess after appendicectomy: A case report

Stump appendicitis, an inflammation of the residual appendix after appendicectomy, presents with all the clinical features of acute appendicitis. This variant poses diagnostic challenges, particularly in patients with right iliac fossa pain.

We present a case of a 58-year-old man who developed an appendiceal stump abscess eight months after laparoscopic appendectomy. In addition to stable vital signs, abdominal examination revealed pain in the right lower quadrant. The CT scan showed a collection with a tubular structure corresponding to a remaining appendiceal stump. He underwent emergency laparoscopic surgery. Intraoperatively, a perforated stump and cecal involvement were noted, necessitating stump resection and abscess drainage.

Literature review underscores stump appendicitis as rare but serious. Surgeons face challenges in accurately identifying the appendix base, crucial for preventing stump appendicitis. Imaging, especially computed tomography, aids diagnosis. Stump appendicitis complications, including necrosis and perforation, emphasize the need for prompt intervention. Differential diagnoses include cecal diverticulitis and duplicated appendix. Imaging techniques, particularly CT, play pivotal roles in diagnosis. Preventive measures include stump length control and heightened suspicion in patients with prior appendectomy. Surgical excision remains the preferred treatment, though optimal approach remains unclear.

Stump appendicitis may manifest months to years post-appendectomy, necessitating vigilant follow-up. Awareness of this complication and prompt management are crucial for favorable outcomes.