Stump appendicitis: a rare and unusual complication after appendectomy. Case report and review of the literature

I NTRODUCTION : Stump appendicitis is a rare but important complication that can occour after an open or laparoscop- ic appendectomy. Although it represents a recognized serious condition that should not be overlooked, it is not often con- sidered by surgeons within the differential diagnoses faced with a patient presenting right iliac fossa abdominal pain, particularly those who present a previous history of appendectomy. M ATERIAL OF S TUDY : A comprehensive review of English literature was performed and 87 cases of stump appendicitis were identified. Each case was charted based on 10 variables and data were analyzed. One original case of stump appen- dicitis after open appendectomy treated at our institution is also described and taken as a model. D ISCUSSION : Several factors may contribute to the etiology of stump appendicitis, mainly related to the length of the residual tissue after appendectomy. A delay in diagnosis, possibly misled by a previous history of appendectomy, represents a risk of complications and possible stump perforation. The imaging studies, especially CT scan, seem to be helpful tools in getting the earliest possible diagnosis. C ONCLUSION : Surgeons should be aware of the occurrence of this rare but dangerous entity, in order to avoid a delay in diagnosis and in the appropriate therapeutic choice. We want to emphasize also the technical recommendations to be respected in course of appendectomy.