A 45 year old man with a 2 day history of nausea and vomiting associated with periumbilical pain that migrates to lower right quadrant,with rebound tenderness,temp38°c, breathing 28b/m,.give diagnosi?

Based on the symptoms described, the most likely diagnosis is acute appendicitis. This is a condition where the appendix becomes inflamed and infected, causing symptoms such as nausea, vomiting, periumbilical pain that migrates to the lower right quadrant, rebound tenderness, and fever. The breathing rate of 28 breaths per minute may indicate the presence of peritonitis, which is a serious complication of appendicitis. It is important for the individual to seek immediate medical attention for further evaluation and treatment, which may include surgical removal of the appendix.

Appendicitis