It was late evening. A young girl of 8 years old, was crying and screaming in pain. The pain she localised it to the right lower quadrant of the abdomen. It has been three days now and the pain was getting worse. The parents took her initially to a general practitioner who then referred her to us. On examination, her pulses were racing and she was warm. Her abdomen was so tender all over but she braved herself to be examined. Her abdomen was tensed and tender. It was also guarded(stiff). She was taking short quick breaths. Having admitted her, she was quickly resuscitated and her pain was relieved. Despite this, the pain was still present. She was booked for surgery with a suspicion of a perforated appendix.

I was notified that she was going into surgery. Not long after, I was called into the operating theatre.

So what do you think is going on?