This patient presented with acute abdominal pain in the ED with concern of obstruction or appendicitis. This is a great reminder that active endometriosis can cause abdominal pain, and in this case, the subtle haziness of the mesentery/omentum on CT may reflect blood products or inflammation related to small implants that are not well seen on imaging. Endometriomas were confirmed on MRI, which also showed a few smaller foci of blood products related to smaller implants in the adnexae.