A 19-yeаr оld femаle cоmplаins оf abdominal pain that began ~60 minutes ago and seems to be getting worse. The patient complains of pain primarily in the RLQ and steady in nature, but the pain initiated in the center of her abdomen. The patient states she is due to start her menstrual cycle “any day now”. The patient states she has had one child and has been pregnant only one time. Vitals: BP is 132/74, HR is 112, RR is 18 and shallow, Temp is 101.8◦F. The patient’s skin is hot, pale with normal capillary refill. She is sitting very still and looks to be in significant pain. The patient’s most likely condition would be: