We report on a 29-year-old patient with highly intense, acute abdominal pain of idiopathic origin (out of proportion), admitted to the emergency department with suspected appendicitis. An ultrasound revealed signs of bowel obstruction, and due to persistent pain despite intravenous morphine analgesia, a computed tomography was performed, revealing a closed-loop obstruction. The patient underwent laparoscopy, where an omental adhesion was identified and surgically resolved. The postoperative course was uneventful. This potentially dangerous diagnosis should be considered even in healthy patients without prior surgeries. Keywords: Acute abdomen, abdominal pain, intestinal obstruction, ileus, closed loop obstruction, emergency medicine.