A 67-year-old man presented to the emergency department of Kuwait Hospital, Sharjah, United Arab Emirates, in 2016 after multiple episodes of biliary vomiting with abdominal pain over the preceding 24 hours. He had had no bowel motion during the previous 10 days. On examination, he was found to have a long-standing asymptomatic inguinoscrotal mass which had first been noticed 30 years before; since then, it had been increasing in size and had recently become irreducible.