Pair each patient presentation with the most accurate acute surgical diagnosis.
- A 45-year-old female presents with severe right upper quadrant pain radiating to the right shoulder, arrested inspiration upon deep palpation of the subcostal margin, and a temperature of 38.0°C (100.4°F).Acute cholecystitis
- A 22-year-old male reports dull periumbilical pain that migrated to the right lower quadrant over the past 24 hours, accompanied by profound anorexia and nausea.Acute appendicitis
- A 68-year-old male with a history of chronic constipation presents with constant left lower quadrant abdominal pain, a fever of 38.5°C (101.3°F), and leukocytosis.Acute diverticulitis
- A 55-year-old male with chronic daily NSAID use presents with the sudden onset of diffuse, severe abdominal pain and a rigid, board-like abdomen on examination.Perforated peptic ulcer
Answer
The presentations map as follows: the 45-year-old female has acute cholecystitis, the 22-year-old male has acute appendicitis, the 68-year-old male has acute diverticulitis, and the 55-year-old male has a perforated peptic ulcer.
Each presentation describes the textbook hallmark symptoms of a specific acute abdominal emergency: right upper quadrant pain with a Murphy sign for acute cholecystitis, migrating periumbilical pain with anorexia for acute appendicitis, left lower quadrant pain in an older adult for acute diverticulitis, and sudden diffuse peritonitis with NSAID use for a perforated peptic ulcer.
Step-by-Step Solution
Key Concept
Classic clinical presentations of acute abdominal surgical emergencies