Question: A 64-year-old woman presented to the emergency department with 24 hours of progressive, sharp, lower abdominal pain accompanied by abdominal distention. Over the prior 2 months, the patient described mild, intermittent abdominal pain along with intermittent loose stools and weight loss. There was no nausea, vomiting, hematochezia, fever, or chills. The past medical history was notable for bilateral lung transplants 4 years previously for sarcoidosis. On physical examination the patient appeared uncomfortable.