Stump Appendicitis and the Diagnostic Challenges: A Systematic Literature Review of Saudi Arabia and Gulf Region 2010-2025

Abstract

Abstract

Stump Appendicitis (SA) is referred to as inflammation of the residual appendiceal stump following an

appendectomy, although it is uncommon but potentially serious condition with diagnostic and therapeutic

challenges. Its clinical presentation may mimic symptoms of appendicitis, while the latency between the

initial surgery and recurrence of symptoms may extend for decades. In some clinical situations diagnostic

delays may arise from low clinical suspicion in patients especially in those with a history of appendectomy.

This review aims to analyze the demographic and clinical characteristics of SA in Saudi Arabia and the Gulf

region, evaluate the diagnostic accuracy, particularly the role of computed tomography (CT) in diagnostic

imaging, assess various surgical management approaches and outcomes; and identify factors that contribute to the diagnostic challenges in these patients.

Focused review of local and regional studies and reports was conducted to explore and assess clinical

pattern, management, and outcome. All article met the inclusion criteria were included. Selected studies

originated from the gulf region. Data-including patient demographics, post-appendectomy time intervals,

imaging findings with emphasis on CT usage, clinical presentations, management strategies, and outcomes were extracted.

The cases reviewed indicate that SA affects a wide age range with nearly equal gender distribution. The

interval between the initial appendectomy and recurrence widely varied. The role of CT in establishing the

diagnosis of SA regarded as a valuable tool, particularly in cases where ultrasonography provided

inconclusive findings. management was tailored according to clinical severity. Delay of diagnosis may result

from low clinical suspicion of the patient’s history of appendectomy.

Stump Appendicitis in prior appendectomy patients might lead to diagnostic challenges in Saudi Arabia and

the Gulf region. CT imaging is often considered for accurate diagnosis. Improving surgical techniques at the

time of initial appendectomy, enhancing clinical awareness and standardized diagnostic protocols may

reduce morbidity and improving outcomes and reduce the delay in diagnosis. More studies are

recommended for further increasing awareness, elucidating risk factors, diagnostic protocols and refine

management strategies.