We report a case of an extremely rare presentation of a sigmoid carcinoma, which presented as an appendicular abscess along with pseudomembranous colitis involving the small bowel. Colo-rectal carcinoma has presented as abdominal wall abscess in the past, but to the best of our knowledge, an incident of colo-rectal carcinoma presenting as an appendicular abscess and later developing pseudomembranous colitis involving the small bowel has never been reported. Such patients’ condition is potentially curable if detected early through careful history taking, examination, investigations and regular screening programs.