Clin Endosc.  2014 Jan;47(1):112-114.

A Case of Endoscopic Removal of a Giant Appendicolith Combined with Stump Appendicitis

• Kim DJ
• Park SW
• Choi SH
• Lee JH
• You KW
• Lee GS
• Moon HC
• Hong GY

Abstract

Stump appendicitis is an acute inflammation of the residual appendix and is a rare complication after appendectomy. The physician should be aware of the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy so that delayed diagnosis and treatment can be prevented. Stump appendicitis is usually treated by surgical resection, and endoscopic treatment has not been reported previously. A 48-year-old man who had undergone appendectomy 35 years earlier presented to the hospital because of right lower quadrant discomfort. A computed tomography scan showed a large stone in the residual appendix. Colonoscopic findings revealed a large, smooth, protruding lesion at the cecum with a stone inside the appendiceal orifice. Endoscopic removal after incision of the appendiceal orifice was performed successfully.

Keyword

Appendicolith; Stump appendicitis; Endoscopic removal

MeSH Terms

Abdominal Pain
Appendectomy
Appendicitis*
Appendix
Cecum
Delayed Diagnosis
Humans
Inflammation
Middle Aged

Figure

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  Fig. 1 Abdominal computed tomography showing stump appendicitis with residual stone. (A) Coronal view. (B) Axial view.

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  Fig. 2 (A) Colonoscopy showing a round, protruding mass covered with normal mucosa and an impacted stone at the appendiceal orifice. (B, C) An approximately 4-mm incision on the appendiceal orifice by using an IT knife. (D, E) Removal of the appendiceal stone using a snare. (F) View of the complete removal of the appendiceal stone.

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