We present a case of a male patient, who was referred to our department due to severe pain beginning in the lower abdomen and then spread diffusely over the whole abdomen lasting for a couple of days. The abdominal ultrasound showed an appendicolith in the appendix with a suspicion of an acute appendicitis with perforation. The patient underwent a laparoscopy with a subsequent conversion to a conventional laparotomy. Appendectomy was performed. The appendix was sent to the pathology department and the pathohistological diagnosis was a moderate chronic appendicitis with the appendix containing an inflammed diverticulum with perforation.