Stump appendicitis

Case contributed by Dr Shanesh Kumar

Presentation

Constant right lower quadrant pain. There were no associated symptoms. His past medical history included an appendectomy. On examination, he was afebrile, haemodynamically stable and his biochemical markers were normal.

Patient Data

Age: 65 years
Gender: Male
CT

CT abdomen and pelvis with intravenous and oral contrast demonstrating right lower quadrant inflammation, centered on the presumed remnant appendix. 

Case Discussion

The patient had an open appendectomy 40 years. Stump appendicitis is rare and has an incidence of 1/50,000 1. He was managed conservatively with intravenous antibiotics and will be followed up in the general surgical outpatients department. 

Of note, a possible differential in this case is right-sided diverticulitis. which, while not nearly as common as left-sided diverticulitis, is nevertheless more common than stump appendicitis.

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