The role of laparoscopic surgery in the management of retained distal part of the appendix : A case report

Abstract

Appendicectomy is one of the most common emergency surgical procedures. Stump Appendicitis is well recognized entity and has been described in the literature. Despite recent advances in imaging techniques, its diagnosis and effective management remain a clinical challenge. We present a 15-year old boy who underwent open appendicectomy 4 months back and came to us with acute abdomen associated with vomiting and fever. imaging revealed the presence of a tubular retained inflammed distal part of the appendix of size 3.5cm lying  in the paracaecal position with approximately 50cc purulent collection around it. Subsequently the patient underwent successful minimal access completion appendicectomy with uneventful postoperative recovery. Histopatholocal examination confirmed the resected structure as an inflammatory remnant of the distal part
of the appendix. To our knowledge there is no report in the southwestern region of Nigeria on laparoscopic completion appendicectomy for remnant distal part appendicitis. We hereby emphasize the importance of complete removal of the appendix not only proximal part but also the distal part, especially in certain locations such as paracaecal, retrocaecal and subhepatic. Minimal access surgery possibly by laparoscopy can be an
option for the management of these patients, with available expertise.

Keywords: Distal Appendix Stump, completion appendicectomy, laparoscopy.