26th April 2024

A 19-year-old female presents with a 24-hour history of abdominal pain that initially started around the umbilicus but has now localised to the right lower quadrant.

A 19-year-old female presents with a 24-hour history of abdominal pain that initially started around the umbilicus but has now localised to the right lower quadrant. She describes the pain as constant and worsening. She also reports a loss of appetite and has had a low-grade fever since last night. There is no history of vomiting, diarrhoea, or urinary symptoms. Her past medical history is unremarkable.

On examination, her temperature is 38.3°C. Abdominal examination reveals tenderness in the right lower quadrant with rebound tenderness. Rovsing’s sign is positive, and she experiences pain on the right side when pressure is applied to the left lower quadrant.

Which is the most likely diagnosis?