Stump appendicitis: A rare clinical entity
An 18-year-old boy was admitted by a physician with a 1 day history of severe periumbilical pain radiating to the right iliac fossa with loss of appetite. There was no history of vomiting, fever, altered bowel habits or urinary symptoms. Patient had undergone laparoscopic appendectomy 2 years back and had an uneventful recovery, but the details of the operative findings and histopathology were unavailable. Positive clinical findings included a right lower quadrant tenderness and leukocytosis i.e. 15,000 cells/mm3 (reference normal range 4-11,000 cells/mm3). A computed tomogram of abdomen showed only small collection in right iliac fossa [] and initial conservative management was planned by the treating physician.\nSurgical consultation was sought after two days as the clinical condition of the patient deteriorated. The patient developed fever, tachycardia and guarding in the right iliac fossa. The patient was subsequently posted for a Diagnostic Laparoscopy after informed consent.\nIntra operative findings included dense adhesions around the ileocecal region. There was a 3cm long inflamed perforated appendicular stump with abscess formation (~ 30-40 ml pus) [Figures and ]. The appendicular stump was defined and divided at the base with an Endo Stapler []. The specimen was sent for histopathology and showed suppurative appendicitis with perforation. Patient had port site wound infection in post operative period and was discharged on 4th post operative day.