title: Stump appendicitis after laparoscopic appendectomy: case report.
abstract: Stump appendicitis is a rare delayed complication of appendectomy. The delay in diagnosis is usually because of a prior history of appendectomy. We report a case of stump appendicitis diagnosed pre-operatively with a computerized tomography (CT) scan after laparoscopic appendectomy. An 18-year-old male presented with a one-week history of lower abdominal pain, nausea and vomiting. He had a history of laparoscopic appendectomy for acute appendicitis. Physical examination revealed tenderness and guarding in the lower abdomen. CT scan showed free pelvic fluid with a tubular structure of about 2.5 cm in length and 0.78 cm in diameter located posterior to the ileo-cecal junction. Laparoscopic exploration confirmed the findings. A residual appendiceal stump was found and dissected from the adhesion and removed. Histopathology showed a residual appendix with transmural neutrophilic infiltration associated with multifocal hemorrhagic necrosis. The postoperative period was uneventful. The diagnosis of stump appendicitis can be challenging. CT scan has proven to be a useful tool for the diagnosis of this rare condition.
authors.affiliation: Department of Surgery,Tawam Hospital in affiliation with Johns Hopkins Medicine, Al-Ain, United Arab Emirates.
authors.forename: Omaima
authors.initials: O
authors.lastname: Bu-Ali
authors.forename: Mohamed
authors.initials: M
authors.lastname: Al-Bashir
authors.forename: Hashim A
authors.initials: HA
authors.lastname: Samir
authors.forename: Fikri M
authors.initials: FM
authors.lastname: Abu-Zidan
mesh_terms: D015746:Abdominal Pain; D000293:Adolescent; D000672:Amputation Stumps / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001062:Appendectomy / Q000009:adverse effects*; D001064:Appendicitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011859:Radiography; D012086:Reoperation