Abstract
Stump appendicitis, also known as remnant appendicitis, is an uncommon entity with little radiologic literature. It is the result of unintentional incomplete appendectomy with subsequent inflammatory changes in the appendiceal remnant. A retrospective review of the radiology and pathology archives at our institution over an 8-year period yielded six surgically/pathologically confirmed cases. Imaging findings at presentation were evaluated, including appendiceal stump length, appendiceal stump diameter, presence or absence of surrounding stranding in the periappendiceal fat, and presence or absence of complication (perforation or abscess). The CT findings of the six cases had an average surgical specimen appendiceal stump length of 3.5 cm (range 2.0–5 cm) and an average appendiceal diameter of 12.3 mm (range 10–16 mm). All six cases demonstrated the presence of periappendiceal inflammatory fat stranding on the CT scan. Range of imaging presentation is reviewed with pictorial examples as well as examples of potential false-positive cases (mimics) including Crohn’s disease, residual surgical drain tract, and epiploic appendagitis. Familiarity with stump appendicitis as well as its imaging mimics may lead to earlier diagnosis and treatment and prevent unnecessary complications.
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References
Rose TF (1945) Recurrent appendiceal abscess. Med J Aust 32:659–662
Subramanian A, Liang M (2012) A 60-year literature review of stump appendicitis: the need for a critical review. Am J Surg 203(4):503–507. doi:10.1016/j.amjsurg.2011.04.009
Kumar A, Sharma A, Khullar R, Soni V, Baijal M, Chowbey PK (2013) Stump appendicitis: a rare clinical entity. J Minim Access Surg 9(4):173–176. doi:10.4103/0972-9941.118835
Liang MK, Lo HG, Marks JL (2006) Stump appendicitis: a comprehensive review of literature. Am Surg 72(2):162–166
Leff DR, Sait MR, Hanief M, Salakianathan S, Darzi AW, Vashisht R (2012) Inflammation of the residual appendix stump: a systematic review. Color Dis 14(3):282–293. doi:10.1111/j.1463-1318.2010.02487.x
Gaetke-Udager K, Maturen KE, Hammer SG (2014) Beyond acute appendicitis: imaging and pathologic spectrum of appendiceal pathology. Emerg Radiol. doi:10.1007/s10140-013-1188-7
Levine CD, Aizenstein O, Wachsberg RH (2004) Pitfalls in the CT diagnosis of appendicitis. Br J Radiol 77(921):792–799
Shin LK, Halpern D, Weston SR, Meiner EM, Katz DS (2005) Prospective CT diagnosis of stump appendicitis. AJR Am J Roentgenol 184:S62–S64
Aschkenasy MT, Rybicki FJ (2005) Acute appendicitis of the appendiceal stump. J Emerg Med 28(1):41–43
Buttrick SS, Choi JJ, Divino CM (2012) Stump appendicitis after open and laparoscopic appendectomies. Am Surg 78(1):143–144
Baldisserotto M, Cavazzola S, Cavazzola LT, Lopes MH, Mottin CC (2000) Acute edematous stump appendicitis diagnosed preoperatively on sonography. AJR Am J Roentgenol 175(2):503–504
Martínez Chamorro E, Merina Castilla A, Muñoz Fraile B, Koren Fernández L, Borruel Nacenta S (2013) Stump appendicitis: preoperative imaging findings in four cases. Abdom Imaging 38(6):1214–1219. doi:10.1007/s00261-013-0008-6
Rhea JT (2000) CT evaluation of appendicitis and diverticulitis. Part I: appendicitis. Emerg Radiol 7:160–172
Heller MT, Hattoum A (2012) Imaging of acute right lower quadrant abdominal pain: differential diagnoses beyond appendicitis. Emerg Radiol 19:61–73
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Johnston, J., Myers, D.T. & Williams, T.R. Stump appendicitis: surgical background, CT appearance, and imaging mimics. Emerg Radiol 22, 13–18 (2015). https://doi.org/10.1007/s10140-014-1253-x
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DOI: https://doi.org/10.1007/s10140-014-1253-x