Stump appendicitis: surgical background, CT appearance, and imaging mimics

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 a...

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Bibliographic Details
Published in:Emergency radiology 2015-02, Vol.22 (1), p.13-18
Main Authors: Johnston, Jennifer, Myers, Daniel T., Williams, Todd R.
Format: Article
Language:English
Subjects:
Appendectomy
Appendicitis - diagnostic imaging
Appendicitis - surgery
Contrast Media
Diagnosis, Differential
Emergency Medicine
Female
Humans
Imaging
Iopamidol
Male
Medicine
Medicine & Public Health
Original Article
Postoperative Complications - diagnostic imaging
Radiology
Recurrence
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
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Summary: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.
ISSN:1070-3004
1438-1435
DOI:10.1007/s10140-014-1253-x