A 73-year-old female smoker presented with a 2-week history of left-sided abdominal pain and 1-day history of fresh rectal bleeding. Past history included cardiac failure for which she was followed up by the cardiologists. There was no significant gastro-intestinal history. On examination she was tender in the left upper quadrant. She had a minimally raised WBC and was passing fresh blood and mucus. An AXR (Image 1) and a CT of the abdomen and pelvis (Images 2a–d) were performed.