Acute Appendicitis Following Appendectomy

Abstract

SummaryBackground: Stump appendicitis is a rare delayed complication of appendectomy. Several diseases present with right lower abdominal pain, and therefore it is occasionally difficult to make a differential diagnosis, especially in patients with a history of appendectomy. In this paper we present our experiences with acute appendicitis following an appendectomy. Patients and Method: We selected five cases from January 2002 to December 2010. The clinical characteristics, imaging studies, treatment, and outcome were recorded. Results: All patients presented with abdominal pain (4 patients with fever). The mean duration of onset was 2 days. All patients had a history of ruptured appendicitis (2 patients showed a combination with generalized peritonitis). The mean duration since the previous appendectomy was 7.54 years. 4 patients underwent an abdominal ultrasound, and all patients underwent abdominal computed tomography, showing again a ruptured appendicitis. 4 of 5 patients had a stump appendicitis. All of the patients showed a good prognosis following surgery. Conclusions: The stump following an appendectomy should be shortened as much as possible. However, sometimes recurrent appendicitis with perforation will develop in patients with complete resection of the appendix. Stump appendicitis is associated with a history of ruptured appendicitis.