Stump Appendicitis in a Pediatric Patient: Late Diagnosis of a Rare Entity. A Case Report and Brief Review of the Literature
Villamizar J1*, Parada O1, Clavijo L2, Díaz A2
1Erasmo Meoz University Hospital,Cúcuta, Colombia.
2University of Pamplona, Faculty of Health, Pamplona, Colombia.
*Corresponding Author: Joaquin Enrique Villamizar Zuñiga, Pediatric Surgeon, Erasmo Meoz University Hospital,Cúcuta, Colombia.
https://doi.org/10.58624/SVOAPD.2026.05.005
Received: February 20, 2026
Published: April 08, 2026
Citation: Villamizar J, Parada O, Clavijo L, Díaz A. Stump Appendicitis in a Pediatric Patient: Late Diagnosis of a Rare Entity. A Case Report and Brief Review of the Literature. SVOA Paediatrics 2026, 5:2, 42-46. doi: 10.58624/SVOAPD.2026.05.005
Abstract
Background: Stump appendicitis is a rare but potentially serious complication caused by inflammation of residual appendiceal tissue after appendectomy. It may occur days to decades following the initial surgery and is frequently associated with delayed diagnosis and increased risk of perforation, reported in up to 70% of cases. Awareness of this entity in pediatric populations remains limited.
Case Presentation: An 11-year-old male with a history of open appendectomy performed two years earlier presented with a five-day history of progressive right lower quadrant abdominal pain and fever (38°C). Physical examination revealed a positive McBurney sign. Laboratory findings showed leukocytosis (16,160 cells/mm³), neutrophilia (82%), and elevated C-reactive protein (134.43 mg/dL), with a modified Pediatric Appendicitis Score (PAS) of 7. Abdominal ultrasound demonstrated a non-compressible tubular structure in the right iliac fossa measuring 10 mm in diameter and 23 mm in length, consistent with stump appendicitis. A multiport laparoscopic completion appendectomy was performed, revealing a 4 cm phlegmonous, non perforated appendiceal stump. Histopathology confirmed transmural polymorphonuclear inflammatory infiltration and mucosal ulceration.
Conclusion: Stump appendicitis should be considered in patients with prior appendectomy presenting with right lower quadrant pain, regardless of the time elapsed since surgery. Early clinical suspicion and appropriate imaging are essential to prevent complications.
Keywords: Appendicitis; Appendectomy; Child; Laparoscopy; Abdominal Pain.