Presented to the emergency department with cramping, constant right abdominal pain. An avid cyclist, his symptoms began 12 hours before admission. A day prior, the patient started experiencing light, constant abdominal pain in the afternoon but decided to go cycling During the night, the abdominal pains grew increasingly worse in intensity and were primarily localized to the right iliac fossa with associated vomiting without relief of nausea. His last bowel movement the day before was described as normal. He had a history of surgery as a child operated on for umbilical hernia which had later recurred, bilateral open surgery due to inguinal hernia and appendectomy. The patient had also been hospitalized 2 years prior with upper abdominal pain where Mallory-Weiss lesions were discovered during gastroscopy and a year after that hospitalized with similar abdominal pain without a diagnosis.