Isolated ischaemic caecal necrosis is an unusual event. Because right colon location is less frequent than left one, it may not be considered in the differential diagnosis of right lower quadrant pain. With the typical symptoms (right-sided abdominal pain and tenderness), patients are suspected of having either appendicitis or caecal carcinoma. CT-scan images of caecal wall thickening are often misinterpretated as acecal neoplasm or abscess. We present a case of isolated ischaemic caecal necrosis misinterpretated as a caecal neoplasm.