title: Laparoscopic management of symptomatic residual appendicular tip: A rare case report.
abstract: Appendectomy is one of the most common emergency surgical procedures. Stump appendicitis is well-recognised entity has been described in the literature. Still, with recent advance in imaging technique, it remains as a clinical challenge for diagnosis and effective treatment. We present a case of 13-year-old boy who underwent laparoscopic appendectomy 3 months back and presented to us with acute abdomen associated with vomiting and fever. Imaging revealed the presence of a tubular residual inflamed tip of the appendix of size 4 cm laying in paracaecal position with approximately 50cc purulent collection around it. Subsequently, the patient underwent successful laparoscopic completion appendectomy with uneventful postoperative recovery. Histopathological examination confirmed that resected structure as an inflammatory residual appendix. For our knowledge, after an extensive search of English literature, no study had described about laparoscopic completion appendectomy for residual tip appendicitis. We authors hereby would like to emphasise the importance of complete removal of appendix not only stump part but also tip, especially in certain locations such as paracaecal, retrocaecal and subhepatic. Laparoscopy can be an option for the management of these patients, in selected cases, and with available expertise.
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: R
authors.initials: R
authors.lastname: Parthsarathi
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: Samrat V
authors.initials: SV
authors.lastname: Jankar
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: Bhushan
authors.initials: B
authors.lastname: Chittawadgi
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: Sandeep C
authors.initials: SC
authors.lastname: Sabnis
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: S Sarvana
authors.initials: SS
authors.lastname: Kumar
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: S
authors.initials: S
authors.lastname: Rajapandian
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: P
authors.initials: P
authors.lastname: Senthilnathan
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: P Praveen
authors.initials: PP
authors.lastname: Raj
authors.affiliation: Department of Surgical Gastroenterology and Minimal Access Surgery, Gem Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
authors.forename: C
authors.initials: C
authors.lastname: Palanivelu