Rarely a patient who has had an appendectomy will present with recurrent appendicitis. This can be a diagnostic challenge (and would probably be missed by most computer-based diagnostic systems).
When should the diagnosis of post-appendectomy appendicitis be considered:
(1) one or more of the following:
(1a) persistent symptoms after appendectomy
(1b) unexplained sepsis after appendectomy
(1c) signs and symptoms of appendicitis following appendectomy
(2) incomplete removal of the appendix at the original surgery
In most cases a small length of the proximal appendix remains ("stump" appendicitis). Clark and Theodorou describe a case which occurred following rupture with abscess, with infection in the distal appendiceal tip.
Differential diagnosis:
(1) adhesions
(2) abscess
(3) other lesion (diverticuli, ovarian cyst, etc.)
To read more or access our algorithms and calculators, please log in or register.
