Cecal diverticula must be differentiated from the more common variety of diverticula that are usually found in the left colon. Cecal diverticula are thought to be a congenital entity. The cecal diverticulum is often solitary and involves all layers of the bowel wall; therefore, cecal diverticula are true diverticula. Diverticula elsewhere in the colon are almost always multiple and are thought to be an acquired disorder. These acquired diverticula are really herniations of mucosa through weakened areas of the muscularis propria of the colon wall. The preoperative diagnosis in the case of cecal diverticulitis is "acute appendicitis" about 80% of the time. If there is extensive inflammation involving much of the cecum, an ileocolectomy is indicated. If the inflammation is well localized to the area of the diverticulum, a simple diverticulectomy with closure of the defect is the procedure of choice. To avoid diagnostic confusion in the future, the appendix should be removed whenever an incision is made in the right lower quadrant, unless operatively contraindicated.