It is no longer there, but there it is: stump appendicitis.

Abstract

Stump appendicitis is a rare complication of appendectomy with an incidence of 1 in 50,000 cases. The most common cause is failure to identify the appendiceal base in severe inflammatory processes. Although the clinical manifestations may be the same as those of appendicitis, the surgical history delays the diagnosis, which is often made during surgical reintervention because imaging tests such as ultrasound (sensitivity of 44% and specificity of 93%) and computed tomography (sensitivity of 97% and specificity of 94%) may overlook it. The diagnosis is made with a mean delay of 2 days and may be associated with complications as perforation.
Although the figures vary, between 55 and 65% of the cases had a history of open appendectomy while the history of laparoscopic appendectomy was reported in only 38% of the cases. Stump length greater than 5 mm seems to be a determining factor in the development of stump appendicitis and the recommended treatment is complete appendectomy. The aim of this review was to identify the surgical history of the included cases, the time interval between the initial and second episode, the clinical presentation, the diagnosis and the treatment implemented to identify possible risk factors and establish preventive measures