The history and clinical exam are most consistant with acute appendicitis.
Other potential causes for a similar presentation include:
- Ovarian pathology, [i.e. cyst or cyst rupture] although elements of Jennifer's history such as the gradual onset of an initially periumbilical pain would not suggest this
- Urinary tract infection - She has some urinary frequency, but negative urine microscopy. The results of culture would further exclude a UTI. Occasionally however an inflammed pelvic appendix can irritate the bladder leading to symptoms mimicing a UTI
- Inflammatory bowel disease - particularly if there is a family history bear in mind that Crohn's presenting as terminal ileitis can present in a similar fashion to appendicitis.