Introduction: Acute appendicitis is a common surgical emergency that requires intervention. The accurate diagnosis remains challenging in some cases despite advances in both minimally invasive surgery and radiology. Stump appendicitis is a rare complication after appendectomy. It is defined as the acute inflammation of the residual appendix. A small number of stump appendicitis cases have been reported.
Case Report: We report a case of stump appendicitis in a 42-year-old female, nine months following a laparoscopic appendectomy. She presented with a 24-hour history of abdominal pain, which started periumbilically and then localized to the right lower quadrant. Physical examination showed tenderness in the right iliac fossa with evidence of rebound and guarding. Laboratory studies were remarkable for leukocytosis. Computed tomography scan of the abdomen and pelvis showed a remnant appendicular segment with a maximum cross diameter of about 1.2 cm, associated with local inflammatory changes and surrounding fat stranding. An open stump appendectomy was performed uneventfully.
Conclusion: Stump appendicitis is a rare but serious complication of appendectomy. It can represent a diagnostic dilemma if the treating clinician is unfamiliar with this rare clinical entity. Prompt recognition is important to avoid serious complications. Proper identification of the appendicular base intraoperatively and leaving the appendix stump shorter than 5 mm decrease the risk of stump appendicitis.

Keywords: Acute appendicitis, Completion appendectomy, Stump appendicitis