Dimaya Roland M, Sahu Novneet
Del Med J. 2016 Sep;88(9):276-8.
Stump appendicitis is a delayed complication of appendectomy. Patients present with symptoms similar to an initial presentation for appendicitis. Diagnosis is often delayed as history of appendectomy often precludes focused workup for an appendiceal source of infection. A 39-year-old female presented to our emergency department with worsening abdominal pain and fever. Se had a past surgical history of a laparoscopic appendectomy approximately 14 months prior to presentation. During her admission, she was diagnosed with ruptured stump appendicitis by computerized tomography (CT) imaging. A percutaneous drain was placed and the patient was discharged with antibiotics. Follow up evaluation revealed clinical improvement, with resolution of peri-appendiceal stump inflammation and subsequent percutaneous drain removal. Completion appendectomy is tentatively scheduled. This case highlights awareness of stump appendicitis as a differential diagnosis for patients with previous appendectomy who present with acute abdominal pain.
阑尾残株炎是阑尾切除术后的一种延迟性并发症。患者表现出与阑尾炎初次发作时相似的症状。由于阑尾切除术史常常使针对阑尾感染源的重点检查受到限制，诊断往往会延迟。一名39岁女性因腹痛加重和发热就诊于我院急诊科。她在就诊前约14个月有腹腔镜阑尾切除术的既往手术史。住院期间，通过计算机断层扫描（CT）成像诊断为阑尾残株破裂。放置了经皮引流管，患者出院时带抗生素。随访评估显示临床症状改善，阑尾残端周围炎症消退，随后拔除了经皮引流管。初步计划进行阑尾残端切除术。该病例强调了对于有阑尾切除术史且出现急性腹痛的患者，应将阑尾残株炎作为鉴别诊断加以关注。
