A 21-year-old man presented to the emergency room with a three-day history of increasing abdominal pain and diarrhea. On examination he had a rigid, flat abdomen with diffuse tenderness, guarding and rebound. Bowel sounds were absent. His temp. was 102 and his WBC count was 18K with a left shift.
The patient was given a pre-op dose of broad-spectrum antibiotic and taken directly to the operating room for exploratory laparoscopy with a presumptive diagnosis of perforated appendicitis. The abdomen was entered through an umbilical Hasson port.
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