A man in his 60s with history of gastroesophageal reflux disease presented to his primary physician for routine follow-up. He reported 1 day of mild, dull, right and left lower quadrant pain that was worse with palpation but was not associated with food, constipation, diarrhea, hematochezia, melena, or nausea. On examination he had normal vital signs and tenderness in right lower quadrant without guarding or rebound. A computed tomographic (CT) scan of the abdomen and pelvis with contrast was ordered to evaluate for diverticulitis and appendicitis.