This patient presented through A&E with chronic lower abdominal pain not confined to a certain area, and not related to her menstrual cycle. Abdomen and pelvis ultrasound was requested to evaluate the ovaries and the appendix, which turned to be negative but pelvic free fluid was detectable. Further evaluation by CT was recommended by the physician on call and demonstrated findings of pelvic congestion syndrome. However, the supine position during scanning may underestimate the size of venous dilatation.