Caecal perforation following trauma is not a very uncommon occurrence but its presentation varies greatly in common clinical practice ranging from the most common symptom of abdominal pain to a well formed collection discharging as a fistula in the Right iliac region. Herein we present a very rare presentation in a 61 year old male patient who presented with clinical history of trauma to the right hip and inflammatory signs in the right flank suggesting an abscess.Patient was managed initially as an abscess with orthopaedic implications but further study discovered it to be a perforated caecum presenting as an impending fistula. Patient was then managed with a right hemicolectomy . Patient’s post operative condition until discharge and follow up were uneventful.