A 31-year-old male presented with abdominal pain for 1 day. The pain started in the epigastric region and spread throughout the abdomen. Physical exam revealed abdominal distention and muscular rigidity with pain on palpation. Laboratory results were notable for leukocytosis. Imaging showed diffuse peritonitis suspected to be from a perforated appendix. The patient underwent an appendectomy where 500cc of serous hemorrhagic fluid was found. The appendix and other organs appeared normal. An enlarged pancreas with softening was noted but no necrosis. A 5cm ovarian cyst was also found and drained. Drains were placed and the abdomen closed.