This chapter presents a 38-year-old man, who was a smoker with a history of alcohol excess, presented as an emergency at another hospital with a 3-week history of right iliac fossa pain, anorexia, and weight loss to illustrate the best care and clinical management of patient requiring colorectal surgery. It presents a consistent approach throughout and as well as outlining the actual management of the case, also offers an honest appraisal of the chosen management route, its successes and areas that could have been managed differently. Pedagogic features such as learning and decision points boxes aid rapid understanding/learning, enabling the reader to improve their patient management.