Gastrointestinal Case Histories - Case 21

Steve was a 21-year-old male college student who complained of pain, nausea with vomiting, and tenderness in the right lower quadrant. The pain was first vague and diffuse, then became more severe in the midepigastric region before localizing in the right lower quadrant. The pain was accentuated by movement, deep respiration, coughing, or sneezing. A mild fever of 102.2° F and a moderate leucocytosis (11,500/cu mm) were present. A marked tenderness was noted over the right lower quadrant at McBurney's point (one-third the distance between the anterior superior iliac spine and the umbilicus). The psoas sign (pain on passive hyperxtension of the thigh) was also present. His vitals were:
Temperature 102.2° F
Pulse 96
BP 140/90
Respiration 18 b/min and shallow
His abdomen was protuberant with decreased bowel sounds. The abdominal x-ray indicated distended bowel loops.

1. What is the diagnosis of this individual?

2. Describe in anatomical terms the location of the organ involved.

3. Locate the midepigastric region and McBurney's point on yourself. Describe these locations below.

4. What is the cause of the fever, pain, and leukocytosis in this person?

5. What is the usual treatment of this disorder?

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