Introduction:
One of the most common presentations with acute abdomen is acute appendicitis. Although rare, appendiceal anomalies can significantly complicate clinical presentations. These anomalies can include structural abnormalities, such as duplication, triplication, horseshoe appendix, congenital stenosis, and atresia, which can cause right lower quadrant pain and lead to misdiagnosis in patients with an acute abdomen.

Aim:
This case study aims to describe a rare case of vermiform appendiceal atresia in a middle-aged woman with an acute abdomen.

Case study:
A 40-year-old woman with no significant medical history presented with abdominal pain, vomiting, and fever. The clinical examination revealed dehydration, tachycardia, and rebound tenderness. Upon exploratory laparotomy, the appendix appeared inflamed with an atretic segment in the distal portion of the appendix. An appendicectomy was performed and she had a smooth recovery. Histopathological examination revealed a fibrous band connecting the tip and body of the appendix with the lumen completely obliterated.

Results and discussion:
Appendiceal atresia is an infrequent surgical entity whose pathogenesis and clinical implications remain largely unknown. Similar to intestinal atresia, which is primarily attributed to vascular accidents during foetal development, the aetiology of appendiceal atresia is presumed to follow the same pathogenesis. Additionally, more understanding of this clinical rarity's long-term implications and prognosis must be understood, including its potential associations with other medical conditions.

Conclusions:
Appendiceal atresia is rare and may complicate the clinical picture of a patient with an acute abdomen. The pathophysiology and long-term consequences of this clinical rarity remain unclear.