Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 8 2 2025 08 24 67 69 Turgavarathan Letchumanan HUSM Vinnod Chiang Department of General Surgery, Hospital Seberang Jaya, Penang, Malaysia Karthik Subramaniam Department of General Surgery, Hospital Seberang Jaya, Penang, Malaysia Siti Rahmah Merican Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Wan Wan Mokhzani Mokhter Wan Mokhter Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia 2025 04 28 Stump appendicitis is a rare complication of appendectomy. It was first described in 1945 by Rose [1]. To date, it remains both a diagnostic dilemma and a management challenge for clinicians. We present a case of a 58-year-old gentleman with a past history of appendectomy, who presented with cardinal symptoms and signs of intestinal obstruction. Assessment with CT abdomen revealed pericecal inflammation, pneumoperitoneum, and multiple intra-abdominal collections; however, stump appendicitis was not identified. He underwent surgery, during which stump appendicitis was diagnosed intraoperatively, and a completion appendectomy was performed. We review the literature regarding the diagnostic challenges and treatment strategies for stump appendicitis. https://ajs.tums.ac.ir/index.php/ajs/article/view/314