Appendicitis AFTER Appendectomy??? (Stump Appendicitis) скачать в хорошем качестве

Appendicitis AFTER Appendectomy??? (Stump Appendicitis)

Stump appendicitis is an uncommon complication occurring after the appendectomy. Patient presents as a case of acute appendicitis, although appendectomy has already been done. The most likely cause is the development of attack of appendicitis in an incompletely excised appendiceal stump, that is usually in stumps having length greater than 5 millimeters. Optimal management includes re exploration and excision of appendiceal stump. The diagnosis of stump appendicitis requires careful assessment of patients history, physical exam and imaging studies. Use of appendiceal critical view, in which appendix placed at 10 o clock, Taeniae coli at at 3 o clock & terminal ileum at 6 o clock, and identification of where taeniae coli merge is paramount to identifying and ligating base of appendix during initial operation. In patients, who have had prior appendectomy, a low index of suspicion is important to prevent delay in diagnosis and identification of complications. Prior history of appendectomy should not be an absolute criterion in ruling out acute appendicitis.