26th April 2024

A 21-year-old male presents with a 36-hour history of abdominal pain.

A 21-year-old male presents with a 36-hour history of abdominal pain. Initially, the pain was dull and located around the umbilicus, but it has since become sharper and shifted to the right lower quadrant. He reports a loss of appetite and has experienced one episode of vomiting. He denies any changes in bowel habits or urinary symptoms. His past medical history is unremarkable.

On examination, the patient appears uncomfortable. His temperature is 37.9°C, and he has a tender, slightly distended abdomen. Palpation reveals significant tenderness in the right lower quadrant, exacerbated by coughing. There is no guarding or rebound tenderness. McBurney’s point tenderness is noted.

Investigations:

Which is the most likely diagnosis?