Acute self-limited ischemia of the fat (omental infarct/epiploic appendagitis) is an important diagnosis to keep in mind when reading contrast CT and flank pain studies, as it can mimic other causes of acute abdominal pain. This case of omental infarct occurred in the more typical location (right abdomen) and is relatively subtle on the axial images, but more well-defined on the coronal images. The small amount of surrounding fluid and fluid in the paracolic gutter help confirm the acute presentation with some associated inflammation, accounting for the patient's pain.