Published: 2020-05-26

Stump appendicitis single centre experience: a retrospective study

Imran A. Khan, Parthasarathi Ramakrishnan, Rajapandian Subbaiah, Senthilnathan Palanisamy, Nalankilli Palanisamy, Senthil K. Ganapathi, Bharath K. Murugan, Chinnusamy Palanivelu


Background: Appendicectomy is the most common surgical procedure done for acute appendicitis worldwide. However, one among 50000 appendicectomy patients may present with recurrent abdominal pain, requiring hospitalization as stump appendicitis and may need completion appendicectomy. There are a few reports addressing management of stump appendicitis in the literature. Here we present our experience of laparoscopic completion appendicectomy over ten-year duration.

Methods: A retrospective evaluation of records of appendicectomy from January 2008 to December 2018. All patients who had stump appendicitis as diagnosis and those who underwent completion appendicectomy were included. There were no exclusions. Details pertaining to presentation, duration of symptoms, records of previous surgery, perioperative and postoperative data was recorded, including follow-up of at least six months.

Results: All 15 patients were managed by laparoscopic completion appendicectomy. Patients age range from 12 to 58 years, 12 were males and 3 female, duration of symptoms was from two to ten days, previous appendicectomy was done 4 to 84 months before, nine were diagnosed by ultrasonography of abdomen and six by CT scan, stump size ranged from 1 to 3.6 cm, mean operating time was 86.4 mins (range, 60-120 minutes). Duration of hospital stay was 3 to 5 days. There were no perioperative morbidity or mortality.

Conclusions: Laparoscopic approach of completion appendicectomy is safe for management of stump appendicitis.


Stump, Appendicitis, Completion appendicectomy, Remnant appendix

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Anderson KD, Parry RL. Appendicitis. In: O’Neill JA, Rowe MI, Grosfeld JL, Fonkalsurd EW, Coran AG, editors. Pediatric surgery. 5th ed. London: Mosby; 1998:1369-1379.

Liang MK, Lo HG, Marks JL. Stump appendicitis: a comprehensive review of literature. Am Surg. 2006;72:162-6.

Greenberg JJ, Esposito TJ. Appendicitis after laparoscopic appendectomy: A warning. J Laparoendosc Surg. 1996;6:185-7.

Uludag M, Isgor A, Basak M. Stump appendicitis is a rare delayed complication of appendectomy: A case report. World J Gastroenterol. 2006;12:5401-3.

Clark J, Theodorou N. Appendicitis after appendicectomy. J R Soc Med. 2004;97:543-4.

Durgun AV, Baca B, Ersoy Y, Kapan M. Stump appendicitis and generalized peritonitis due to incomplete appendicectomy. Tech Coloproctol. 2003;7:102-4.

Mangi AA, Berger DL. Stump appendicitis. Am Surg. 2000;66:739-41.

Truty MJ, Stulak JM, Utter PA, Solberg JJ, Degnim AC. Appendicitis after appendectomy. Arch Surg. 2008;143:413-5.

Manoglu B, Niflioglu GG, Uysal E. A rare case: appendectomy after connected stump appendicitis perforation of the cecum. J Clin Anal Med. 2015;6(4):539-41.

Kanona H, Samaraee AA, Nice C, Bhattacharya V. Stump appendicitis: a review. Int J Surg. 2012;10(9):425-8.

Onder A, Kapan M, Boyuk A, Tekbas G, Gumus M. Stump appendicitis after appendectomy. Kolon Rektum Hast Derg. 2010;20(4):188-91.

Leary ODP, Myers E, Coyle J, Wilson I. Case report of recurrent acute appendicitis in a residual tip. Cases J. 2010;3:14.

Baldisserotto M, Cavazzola S, Cavazzola LT, Lopes MHI, Mottin CC. Acute edematous stump appendicitis diagnosed preoperatively on sonography. AJR Am J Roentgenol. 2000;175:503-4.

Shin LK, Halpern D, Weston SR, Meiner EM, Katz DS. Prospective CT diagnosis of stump appendicitis. AJR Am J Roentgenol. 2005;184:62-4.

Erzurum VZ, Kasirajan K, Hashmi M. Stump appendicitis: a case report. J Laparoendosc Adv Surg Tech A. 1997;7(6):389-91.

Rao PM, Sagarin MJ, Cabe MCJ. Stump appendicitis diagnosed preoperatively by computed tomography. Am J Emerg Med. 1998;16(3):309-11.

Roberts K, Starker L, Duffa A, Bell R, Bohkari J. Stump appendicitis: a surgeon’s dilemma. JSLS. 2011;15(3):373-8.