In this study, we aimed to investigate the properties of events of isolated cecal necrosis related with diverticulum, the difficulties of diagnosis and the risk factors. In physical examination of a male patient presented to the emergency department of Tepecik Training and Research Hospital with right lower quadrant abdominal pain, the findings were evaluated as acute abdomen. The patient had chronic renal failure, chronic low blood pressure, ischemic heart failure, acromegaly and diabetes mellitus, and he was operated urgently. Isolated cecal necrosis was observed peroperatively. Right hemicolectomy and ileocolic anastomosis was performed as a surgical procedure. He was followed up in the intensive care unit postoperatively with active fluid - electrolyte resuscitation and appropriate antibiotherapy. The patient with various comorbidities died fifteen day after surgery. Isolated cecum necrosis should be considered in the differential diagnosis of elderly patients and patients with comorbid disease presenting with acute abdomen. Physical examination findings of right lower quadrant abdominal pain could be misdiagnosed as acute appendicitis.