A 37-year-old woman with a history of cyclic lower abdominal pain and nausea presented to the emergency department with acute-onset right lower quadrant (RLQ) pain and nausea for 1 day, but no fever. Vital signs were normal. Physical examination revealed RLQ tenderness. Laboratory examination included a urinalysis, the result of which was negative, and a white blood cell count, which revealed a mild leukocytosis of 11.6 K/μL. Pelvic ultrasonography was obtained, which showed a right ovarian cyst but without evidence of torsion. Computed tomography (CT) of the abdomen/pelvis was performed, which showed an enlarged, dilated appendix of 11 mm in diameter (Figure 1), which on comparison with a prior CT examination from 5 years prior showed a similarly enlarged, dilated appendix.