The patient is a 21 year old male who presented with a history of sudden onset of abdominal pain, first generalized, and then localizing to the RLQ. The pain was accompanied with anorexia and nausea. It has become increasingly more severe over the past 3 hours so that the patient now cannot walk. He had one episode of vomiting, and has a low-grade fever of 100. On examination the patient was in acute distress due to pain. Palpation of the abdomen showed generalized tenderness with marked pain in the RLQ and rebound pain. STAT CBC showed leukocytosis of 21,000. Abdominal ultrasound was ordered.
The patient is a 21 year old male who presented with a history of sudden onset of abdominal pain, first generalized, and then localizing to the RLQ. The pain was accompanied with anorexia and nausea. It has become increasingly more severe over the past 3 hours so that the patient now cannot walk. He had one episode of vomiting, and has a low-grade fever of 100. On examination the patient