Our Summary

This research paper discusses two rare conditions related to appendicitis: stump appendicitis and recurrent appendicitis.

Stump appendicitis is inflammation in the remaining appendicular tissue after an appendectomy (surgery to remove the appendix). This condition is rare and occurs in about 1 in 50,000 cases. It’s important to diagnose stump appendicitis quickly to avoid complications like abscesses (pockets of pus), perforation (holes or tears in the tissue), and sepsis (a serious infection that can spread throughout the body).

Recurrent appendicitis, on the other hand, is when a person experiences multiple episodes of appendicitis-like symptoms. These episodes typically last 24 to 48 hours, and the time between episodes can range from weeks to years. During this time, the patient may not have any symptoms. This type of appendicitis is also rare, but doctors should be aware that it’s possible, even for people who’ve had their appendix removed.

The paper emphasizes the importance of considering these unusual conditions in patients who come to the emergency room with recurring pain on the right side of their abdomen.

FAQs

  1. What is stump appendicitis?
  2. Can appendicitis recur even after an appendectomy?
  3. What are the possible complications if stump appendicitis is not diagnosed in time?

Doctor’s Tip

A helpful tip a doctor might tell a patient about appendectomy is to watch out for any signs of infection or complications after the surgery, such as fever, increasing abdominal pain, or redness and swelling around the incision site. It is important to follow the post-operative care instructions provided by the surgeon and to seek medical attention if any concerning symptoms develop.

Suitable For

Patients who are typically recommended for an appendectomy include those with acute appendicitis, recurrent appendicitis, and stump appendicitis. Acute appendicitis is a common condition that requires surgical removal of the appendix to prevent complications such as abscess formation, perforation, and sepsis. Recurrent appendicitis, although rare, may present with similar symptoms as acute appendicitis but with symptoms subsiding within 24 to 48 hours. Stump appendicitis, an acute inflammation of residual appendicular tissue, is a rare post-operative complication that requires prompt diagnosis and surgical intervention. Emergency physicians should be aware of these atypical presentations of appendicitis to ensure timely management and prevent associated morbidities.

Timeline

  1. Patient experiences initial symptoms of appendicitis, such as abdominal pain, nausea, vomiting, and fever.
  2. Patient seeks medical attention and is diagnosed with acute appendicitis.
  3. Patient undergoes appendectomy surgery to remove the inflamed appendix.
  4. Patient experiences recovery period post-surgery, which may include pain management and monitoring for any complications.
  5. Patient is discharged from the hospital once they are deemed stable and able to resume normal activities.
  6. Patient experiences relief from symptoms and improved overall health after the appendectomy.
  7. In rare cases, patient may develop stump appendicitis, characterized by recurrent symptoms of appendicitis due to inflammation of residual appendicular tissue.
  8. Patient undergoes further evaluation and treatment for stump appendicitis, which may include additional surgery.
  9. Patient continues to be monitored for any potential complications or recurrent appendicitis in the future.

What to Ask Your Doctor

  1. What are the symptoms of stump appendicitis and how is it diagnosed?
  2. What is the risk of developing stump appendicitis after an appendectomy?
  3. How is recurrent appendicitis different from a typical episode of acute appendicitis?
  4. What are the treatment options for stump appendicitis or recurrent appendicitis?
  5. Are there any specific precautions or follow-up care I should take after an appendectomy to reduce the risk of stump appendicitis?
  6. How can I differentiate between normal post-operative pain and symptoms that may indicate stump appendicitis?
  7. Are there any warning signs or red flags that I should watch out for that may indicate a complication related to the appendix after surgery?
  8. What should I do if I experience recurrent abdominal pain after an appendectomy?
  9. Are there any specific tests or imaging studies that can help diagnose stump appendicitis or recurrent appendicitis?
  10. What is the prognosis for patients who develop stump appendicitis or recurrent appendicitis?

Reference

Authors: Wong K, Ozgediz DE, Dodington J. Journal: Am J Emerg Med. 2020 Jun;38(6):1295.e3-1295.e4. doi: 10.1016/j.ajem.2020.01.011. Epub 2020 Jan 7. PMID: 31948784