A 20-year-old female presents to the emergency department with central, dull, abdominal pain. She was quite well until the early hours of that morning. In the afternoon, she vomited some of her last night’s supper and then some greenish fluid. She then sensed that the pain had moved to her lower right abdomen, was much worse and hurt her if she moved around in the bed. Her bowel movement was normal until the pain began.
There were no urinary symptoms. She had never experienced a pain like this before. Examination Appearance: Flushed and apprehensive with foetor oris Tongue: Heavily coated Temperature: 38.0°C Pulse: 96 beats per minute The abdomen was not distended, but there was marked tenderness in the right iliac fossa with a rigidity of the abdominal wall in this area. Bowel sounds were heard, but only after listening for a couple of minutes with a stethoscope. Rectal examination:…
