Stump Appendicitis - A Laparoscopic Surgeon's Dilemma
Stump appendicitis is placed through the recurrent inflammation in the residual appendix following laparoscopic or open appendicectomy in which appendix continues to be only partially removed during an appendectomy for appendicitis. There is a notion that stump appendicitis is a new phenomenon that mainly is situated laparoscopically performed appendectomies. A minimum of theoretically, you will find the potential for a heightened incidence of stump appendicitis in laparoscopic surgery due to insufficient a 3-dimensional perspective, as well as the lack of tactile feedback. Subsequently, a longer stump could be put aside. However, in sharp contrast to this theoretical assumption stands the truth that 66% of the reported cases occurred after open appendectomies.
Stump appendicitis is indeed a and sure underreported disease process in gastrointestinal surgery. Although a hard-to-find complication after appendectomy, it might and does occur after both laparoscopic and open appendectomies. It's to be definitely determined whether or not the incidence on this is actually increasing with laparoscopic appendectomies as claimed by some. Stump appendicitis can simply represent a diagnostic dilemma if your treating physician is unaware of this uncommon phenomenon. During surgery, a severely inflamed completely or partially lying retrocecal appendix may be one of the contributing factors bringing about the misidentification from the cecal appendiceal junction. And a stump longer than 3mm left out throughout the initial surgery can bring about appendicitis after appendectomy.
Several factors influence the appearance of stump appendicitis. One common issue is the right identification from the lower appendix, ie, the cecal appendiceal junction. Misidentification with the cecal appendiceal junction usually occur more often with extensive inflammation from the appendix, that may, but will not necessarily, extend on the cecum. Additionally, a total or partial retrocecal lying appendix, ie, the beds base is retrocecal or perhaps a area of the appendiceal shaft lies retrocecal and also the tip turns back and is also easily visualized intraperitoneally and therefore the the main appendix that disappears from the retrocecal area is misidentified because base and falsely transected leaving a stump behind. General recommendations for the resection from the acutely inflamed appendix either in open or laparoscopic surgery add the proper identification and visualization in the lower appendix or cecal appendiceal junction.
|Older Post||Home||Newer Post|