title: Stump appendicitis: a surgeon's dilemma.
abstract: BACKGROUND
  Stump appendicitis is defined by the recurrent inflammation of the residual appendix after the appendix has been only partially removed during an appendectomy for appendicitis. Forty-eight cases of stump appendicitis were identified in the English literature.
  
  
  METHODS
  The institutional CPT codes were evaluated for multiple hits of the appendectomy code, yielding a total of 3 patients. After appropriate approval from an internal review board, a retrospective chart review was completed and all available data extracted. All 3 patients were  diagnosed with stump appendicitis, ranging from 2 months to 20 years after the initial procedure. Two patients underwent a laparoscopic and the one an open completion appendectomy. All patients did well and were discharged home in good condition.
  
  
  CONCLUSIONS
  Surgeons need a heightened  awareness of the possibility of stump appendicitis. Correct identification and removal of the appendiceal base without leaving an appendiceal stump minimizes the risk of stump appendicitis. If a CT scan has been obtained, it enables exquisite delineation of the surrounding anatomy, including  the length of the appendiceal remnant. Thus, we propose that unless there are other mitigating circumstances, the completion appendectomy in cases of stump appendicitis should also be performed laparoscopically guided by the CT findings.
authors: Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut 06510, USA. kurt.roberts@yale.edu
authors: Kurt E
authors: KE
authors: Roberts
authors: Lee F
authors: LF
authors: Starker
authors: Andrew J
authors: AJ
authors: Duffy
authors: Robert L
authors: RL
authors: Bell
authors: Jamal
authors: J
authors: Bokhari
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods; D001064:Appendicitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed