Caecal diverticulosis is a rare cause of ileocoecal pain in western population. It represents 3.6% of all colonic diverticular disease. Signs and symptoms of this disease may mimic acute appendicitis and it is found in one in every 300 appendicectomies. Giving its low incindence the correct diagnosis is usually intraoperative. Eighty-three years old male presented to the surgical admission unit with a two days long history of pain in ileocaecal region. The pain started suddenly, it was constant and worsened on cough and excertion. He was afebrile, denied nausea and vomiting, changes in bowel movements and urination. The abdomen was not distended, it was soft and tender in low right quadrant, without organomegaly. Renal sucussion was negative. There were no signs of hernias. There were traces of normal stool on the rectal examination. Blood tests revealed an elevated total leukocyte count with granulocytosis and elevated parametrs of inflamation. A provisional diagnosis of acute appendicitis was made. Taking into consideration the atypical presentation we decided to do the multislice computed tomography (MSCT) of the abdomen. It revealed a heterogenous soft tissue mass in the area of right hemicolon infiltrating the surrounding fat tissue. The patient was operated on the same day. The procedure revealed a normal looking appendix and caecal diverticulum with an inflamed wall with localized perforation. We performed a right hemicolectomy. The postoperative course was uneventful and the patient made a full recovery. Caecal diverticulosis, although a rare disease in the westwrn world should be taken into consideration in patients with pain in right lower quadrant of the abdomen. The management of this disease should be individual, depending on patient's health status and the stage of disease in the moment of diagnosis. Management of patients with confirmed caecal diverticulitis can be conservative or surgical. Surgical treatment include diverticulectomy, ileocaecal resection and right hemicolectomy.

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