Appendicitis often known as 'disease with a thousand faces'. When ruptured/ perforated, it developed peritonitis. The most likely differential diagnosis when the signs & symptoms appear in young female adults is pelveoperitonitis or PID. Are there any practical ways to differentiate in sure about those two since the impact to the patient is crutial when applying treatment (PID usually non-operative) ? Douglas punction sometimes not helpful since the pus already had matured (forming gel-like fibrin-to-be).
Intravaginal USG?