Stump appendicitis. A case report

INTRODUCTION: Today, the diagnosis of SA is usually not considered as the etiology for right lower quadrant pain in patient with history of appendectomy, resulting in delaying making the correct diagnosis and treatment. Obviously, other more common causes should be excluded first. DISCUSSION: Stump appendicitis (SA) was first described by Rose in 1945. The commonest presenting symptom are abdominal pain (right lower quadrant pain 59%, non specific abdominal pain 16%, and central abdominal pain radiating to the right lower quadrant 14%). PRESENTATION OF CASE: A 54-year-old appendectomized woman presented with recent history of abdominal pain with periumbilical pain radiating to the right side and in the right iliac fossa, in the absence of fever, vomiting or other symptoms. Elective colonoscopy revealed appendicular orifice clogged by big fecalith, with hyperemic surrounding mucosa and CT confirmed “stump appendicitis”. After 30 days of therapy with metronidazole 500 mg/day and mesalazine 1000 mg × 2/day, the patient was submitted to surgery and appendectomy was performed, with a specimen of 24 mm stump appendicitis. CONCLUSION: SA may well be considered as one of the differential diagnoses of acute right lower abdominal pain even in patients with history of appendicectomy.