Stump Appendicitis: A 25-Year Review of Pathophysiology, Diagnosis, and Management (2000-2025)

Acute appendicitis is one of the most common causes of right lower quadrant (RLQ) abdominal pain, and appendectomy remains the standard treatment. However, residual appendiceal tissue may persist after surgery and subsequently become inflamed, resulting in stump appendicitis, a rare but clinically significant condition. This review summarizes the current literature on stump appendicitis from 2000 to 2025, focusing on pathophysiology, clinical presentation, diagnostic modalities, and management strategies. A comprehensive search of PubMed, Google Scholar, and Cochrane databases was performed, and relevant English-language studies were analyzed. Reported cases span a wide age range, with variable intervals between index appendectomy and presentation. Most patients present with RLQ pain and imaging findings consistent with appendiceal inflammation, although diagnosis is often delayed due to low clinical suspicion. Computed tomography remains the diagnostic modality of choice. Management is typically completion appendectomy; however, selected uncomplicated cases may be initially managed conservatively with antibiotics, with or without interval surgery. Complicated cases may require percutaneous drainage or more extensive resection. Stump appendicitis remains under-recognized, and greater awareness, standardized reporting, and prospective studies are needed to improve diagnosis and guide management.