Severe generalized abdominal pain of 2 hours duration. The pain was colicky in nature throughout the abdomen, with occasional burning sensation in the epigastric region and pain radiating to the back. There was constipation with one episode of vomiting. This presentation was the second such episode; the patient had the same pain 3 years before and was treated conservatively with IV fluids. On examination: BP:145/84, PR:113, SPO2: 100%, Pain score: 10/10. Abdomen was mildly distended with generalized tenderness and guarding mainly on the the left side of the abdomen. Initial management with IV fluids and analgesia.