A 55-year-old obese female presents with a two-day history of left lower quadrant (LLQ) pain, nausea, anorexia, and low-grade fevers. The pain is constant, moderately severe, and non-radiating, with no clear precipitating factor. She has not eaten in 24 h due to poor appetite and reports no bowel movement for 48 h. She denies vomiting or bloody or black stools and has no recent change in bowel habits, though she has a long history of constipation. She has noted similar pain in the past, but never this severe, and has never sought medical attention before. She has never had a screening colonoscopy. Her past medical history includes hypertension and diabetes, with no prior surgeries. On physical examination, blood pressure is 130/70 mmHg, heart rate 110/min, temperature is 38.2 °C, and respiratory rate is 16/min. Abdominal exam reveals mild distention, no surgical scars, and no masses. Bowel sounds are absent. The LLQ is moderately tender to palpation with guarding and no rebound tenderness. The remainder of the abdomen is nontender. Rectal exam is unremarkable. Pelvic exam reveals no cervical motion tenderness and no adnexal masses. Laboratory examination demonstrates a white blood cell (WBC) count of 16 × 103/μL (normal 4.1–10.9 × 103/μL) with a left shift, hemoglobin of 13 g/dL (12–15 g/dL), hematocrit 39% (35–46%), normal electrolytes, and a normal urinalysis.