The patient presented one-day history of acute abdominal pain (colicky), distention, and nausea and a past history of appendectomy 4 years ago.

CT abdomen performed as an emergency showed: closed ileal bowel loop obstruction with strangulation and right iliac fossa appendicular stump forming a mucocele.

Laparotomy was done showed a segment of ileum was gangrenous, the appendicular stump was edematous with gelatinous material within it, resection anastomosis was done and an appendicular stump resection.

Histopathology: Low-grade mucinous neoplasm of the appendix with positive proximal margin.

The case was discussed with medical oncology and advised to do right hemicolectomy.