Stump appendicolith removal using a pancreaticobiliary scope in an elderly patient: A case report

doi:10.4253/wjge.121212

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Endosc. Jul 16, 2026; 18(7): 121212
Published online Jul 16, 2026. doi: 10.4253/wjge.121212

Stump appendicolith removal using a pancreaticobiliary scope in an elderly patient: A case report

Wei Li, Mei Xiao, Dan-Dan Wu, Kai-Guang Zhang, Chao Ye

Wei Li, Mei Xiao, Kai-Guang Zhang, Department of Digestive Disease, The First Affiliated Hospital of USTC, Hefei 230001, Anhui Province, China

Dan-Dan Wu, Endoscopic Center, The First Affiliated Hospital of USTC, Hefei 230001, Anhui Province, China

Chao Ye, Department of Digestive Disease, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China

Co-first authors: Wei Li and Mei Xiao.

Author contributions: Li W and Xiao M contributed equally to this article, they are the co-first authors of this manuscript; Li W was responsible for the study concept and design, performed the literature review, and drafted the initial manuscript; Xiao M performed the endoscopic procedure, assisted in patient management, and contributed to manuscript revision; Wu DD served as the endoscopic nurse during the procedure, assisted in the operation, and contributed to the documentation of intraoperative findings; Zhang KG participated in the clinical management of the patient, reviewed the imaging studies, and provided critical revisions to the manuscript; Xiao M obtained informed consent, supervised and performed the endoscopic procedure; Ye C supervised entire study, and finalized the manuscript for submission; and all authors have read and approved the final version of the manuscript.

AI contribution statement: We engaged a professional agency to refine the language of the article and re-evaluate the AI percentage. AI tools were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Supported by National Natural Science Foundation of China, No. 82300707.

Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. The patient was informed that his personal information would be kept confidential and that anonymized data would be used for scientific publication.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Chao Ye, PhD, Academic Fellow, Vice Director, Department of Digestive Disease, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Hefei 230001, Anhui Province, China. yechao850606@ustc.edu.cn

Received: March 21, 2026
Revised: May 3, 2026
Accepted: June 23, 2026
Published online: July 16, 2026
Processing time: 118 Days and 23.5 Hours

Abstract

BACKGROUND

Stump appendicitis is a rare complication following appendectomy, often diagnosed late due to nonspecific symptoms. The presence of appendicoliths in the stump is extremely uncommon and challenging to diagnose in elderly patients, as symptoms can be subtle and imaging findings inconclusive. We present a unique case of stump appendicitis with appendicolith incarceration occurring 60 years post-appendectomy, successfully treated with a pancreaticobiliary scope.

CASE SUMMARY

An 89-year-old male presented with persistent right lower abdominal pain for over one year, 60 years after undergoing an open appendectomy. Physical examination revealed mild tenderness. Laboratory tests and imaging results were unremarkable. Colonoscopy identified a fecal stone lodged in the appendiceal orifice. A pancreaticobiliary scope was employed to successfully remove the impacted fecalith using a basket and irrigation. The patient experienced an uneventful recovery and remained asymptomatic at follow-up.

CONCLUSION

Stump appendicolith should be considered in elderly patients with prior appendectomy. A pancreaticobiliary scope provides a safe treatment option.

Keywords: Stump appendicitis; Appendicolith; Pancreaticobiliary scope; Elderly patient; Case report

Core Tip: In a patient aged 89 years, we report a rare occurrence of stump appendicitis with appendicolith incarceration 60 years after appendectomy. Subtle symptoms and insignificant imaging made diagnosis a challenge. Colonoscopy showed the affected fecalith that was removed successfully with a pancreaticobiliary scope. Therefore, surgery was avoided. This case highlights the necessity to take into consideration the stump appendicolith in elderly patients with chronic abdominal pain and previous appendectomy. In the event of failure of conventional imaging, colonoscopic evaluation of the appendiceal orifice is necessary. The pancreaticobiliary scope is a safe, minimally invasive option to the management of stump appendicoliths in high-risk patients.