A 48-year-old male presents with 2 weeks of severe right lower quadrant abdominal pain and inguinal pain. The patient had similar pain 2 weeks ago, was referred to a surgery clinic, but was lost to follow up. The pain has been progressively worsening over the last 2 days. It’s now severe, associated with nausea and vomiting, does not radiate, and it is worsened with coughing and sneezing. He also endorses polyuria for an unknown length of time. His last bowel movement was 3 days ago. He denies diarrhea, constipation, hematochezia, melena, dysuria, hematuria, or recent trauma.