Anatomymiddle twist
A 19-year-old man has had 20 hours of pain that began around the umbilicus and has settled in the right lower abdomen, with anorexia and a temperature of 37.9 C. At laparoscopy the appendix is inflamed and lies behind the caecum, fixed against the posterior abdominal wall.
Which one of the following examination findings was most likely present in this man before his operation?