This case involves a 32-year-old male patient with a past medical history of ischemic colitis. He presented to an urgent care facility with complaints of abdominal pain. The patient reported that the pain was associated with chills, dry heaves and radiated from his lower abdomen upwards. The patient described the pain as 10/10, and noted that he had not had a bowel movement for several days. Nevertheless, the patient was discharged by the physician with a diagnosis of constipation. The patient called the facility some time later to let them know that his pain had gotten worse, but he was told to wait until morning to see a doctor. Finally, the patient presented to the ER, at which point an exploratory laparotomy was performed and a perforation identified in his colon. The patient required a significant resection of his small and large intestines, and he must now wear a colostomy bag.