By Prof. Kumara Dissanayake (D. M. A. Kumara), Professor in Gynaecological Endoscopy, Rajarata University of Sri Lanka — Rajarata Gynaecological Endoscopy Center (RAGEC).
Dissanayake D, Jayarathna I. “The role of laparoscopy in gynaecological practice for diagnosis of stump appendicitis as a rare cause of chronic pelvic pain.” Sri Lanka Journal of Obstetrics and Gynaecology, 2021; 43(3).
Overview
Chronic pelvic pain is a common and often frustrating presentation, with a long list of possible causes. This report describes how diagnostic laparoscopy identified stump appendicitis — inflammation of a residual appendiceal stump left behind after a previous appendicectomy — as the unexpected source of a patient’s pain.
Clinical message
Stump appendicitis is rare but can mimic gynaecological pathology.
It should be considered even in patients who have “already had their appendix removed.”
When imaging is inconclusive, laparoscopy is both diagnostic and therapeutic, allowing the cause to be found and treated in a single procedure.
Why it matters
The case reinforces the value of laparoscopy in the work-up of chronic pelvic pain and reminds clinicians to keep a broad differential — including surgical causes outside the reproductive tract.
