Stump appendicitis

Case contributed by Pavan Borra
Diagnosis almost certain


Acute abdominal pain for 3 days, post-appendectomy 3 years ago.

Patient Data

Age: 20 years
Gender: Female

Reversal of SMA and SMV relationship noted with small bowel loops towards the right and large bowel to left suggestive of intestinal non-rotation.

A blind-ending bowel loop noted arising from cecum at the midline hypogastrium with calculus at base suggesting swollen appendicular stump with appendicolith.

Case Discussion

Findings of stump appendicitis were confirmed intra-operatively. Differential diagnosis included Meckel diverticulitis.

Non-rotation is a rare incidental abnormality in which entire small bowel is placed to the right of midline and large bowel to left. This leads to an aberrant position of appendix and cecum.

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