Open AccessLaparoscopic management of symptomatic residual appendicular tip: A rare case report
Author(s) -
R Parthsarathi,
Samrat V Jankar,
Bhushan Chittawadgi,
Sandeep C Sabnis,
Saravana S. Kumar,
Subbiah Rajapandian,
P. Senthilnathan,
Praveen Raj,
C. Palanivelu
Publication year - 2017
Publication title -
journal of minimal access surgery
Language(s) - English
Resource type - Journals
eISSN - 0972-9941
pISSN - 1998-3921
DOI - 10.4103/0972-9941.199610
Subject(s) - medicine , appendix , appendicitis , laparoscopy , surgery , acute appendicitis , general surgery , abdomen , emergency department , histopathological examination , vomiting , radiology , paleontology , pathology , psychiatry , biology
Appendectomy is one of the most common emergency surgical procedures. Stump appendicitis is well-recognised entity has been described in the literature. Still, with recent advance in imaging technique, it remains as a clinical challenge for diagnosis and effective treatment. We present a case of 13-year-old boy who underwent laparoscopic appendectomy 3 months back and presented to us with acute abdomen associated with vomiting and fever. Imaging revealed the presence of a tubular residual inflamed tip of the appendix of size 4 cm laying in paracaecal position with approximately 50cc purulent collection around it. Subsequently, the patient underwent successful laparoscopic completion appendectomy with uneventful postoperative recovery. Histopathological examination confirmed that resected structure as an inflammatory residual appendix. For our knowledge, after an extensive search of English literature, no study had described about laparoscopic completion appendectomy for residual tip appendicitis. We authors hereby would like to emphasise the importance of complete removal of appendix not only stump part but also tip, especially in certain locations such as paracaecal, retrocaecal and subhepatic. Laparoscopy can be an option for the management of these patients, in selected cases, and with available expertise.