مريض يُشتبه بالتهاب الزائدة، كان عنده ألم شديد في الجهة اليمنى السفلى، ثم قال فجأة إن الألم خف كثيراً، وبعد ساعة صار البطن صلباً كاللوح وارتفعت حرارته إلى ٣٩. ما التفسير الأرجح؟

A client with suspected appendicitis had severe right lower quadrant pain, then suddenly said the pain was much better. An hour later his abdomen is board-like and his temperature is 39 °C. What is the most likely explanation?

1. The pain has shifted because of gas in the colon
2. The appendix has ruptured and peritonitis is starting
3. A minor muscle spasm from lying in bed too long
4. The inflammation is improving and responding to treatment

Answer: B) The appendix has ruptured and peritonitis is starting. Sudden pain relief followed by a rigid abdomen and fever is the classic pattern of rupture and peritonitis, needing urgent surgical review. Laxatives and heat packs are avoided because they raise the risk of rupture.