Double trouble: a rare presentation of mucocele of appendix

Appendix is a blind ending tubular structure present at the convergence of three tenia coli base caecum. Most commonly presented to out-patient department with features appendicitis, but mucocele appendix secondary malignant etiology rare clinical finding, more than half patients are asymptomatic in their presentation. An accurate diagnosis and proper treatment protocols necessary for its management. If treated incorrectly may lead pseudomyxoma peritonei. A case 54-year-old man right lumbar pain, duration 1 week, findings ultrasonography (USG) abdomen reported as ill-defined collection front psoas muscle (psoas abscess). Hence contrast-enhanced computed tomography (CECT) pelvis was performed suggestive proximal ureteric calculus (8 mm) hydronephrosis. After obtaining consent, patient underwent open appendectomy ureteroscopic lithotripsy (URSL) + double J stenting. Post-operative period uneventful histopathology specimen revealed origin. In presenting sided abdominal broad spectrum differential should be considered evaluated accordingly.