Abstract
Background
Acute appendicitis is one of the most common surgical emergencies, and it is treated
definitively with appendectomy. Recurrent appendicitis is a rare entity, being reported
after approximately 1 in 50,000 appendectomies. It is typically caused by inflammation
of the appendiceal stump. Inflammation of a retained appendiceal tip is a unique entity
that can also cause recurrent appendicitis and presents similarly to primary appendicitis.
Case Report
We present a case of a 50-year-old man who had undergone laparoscopic appendectomy
1 year earlier and who subsequently presented with a chief complaint of right lower
quadrant abdominal pain. The diagnosis of recurrent appendicitis caused by a retained
appendiceal tip was made after a computed tomography scan. The patient underwent successful
laparoscopic removal of the retained appendiceal fragment.
Why Should an Emergency Physician be Aware of This?
The etiology of recurrent appendicitis is separate from the stump appendicitis that
has been well described in the literature. Retained tip appendicitis poses a diagnostic
dilemma because it is uncommon and, if missed, can lead to complications, such as
perforation and severe sepsis. Recurrent appendicitis must be in the differential
diagnosis for patients who are post-appendectomy and who present with right lower
quadrant abdominal pain.
Keywords
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Article info
Publication history
Published online: June 04, 2019
Accepted:
March 30,
2019
Received in revised form:
March 6,
2019
Received:
November 17,
2018
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
