There is bilateral maxillary sinus tenderness. Neck supple without adenopathy. Heart regular without murmurs. Abdomen flat, guarding, moderate non-localized tenderness and rebound. A Murphy's sign cannot be reliably elicited.
Bowel sounds are active.
Testes are normal. No CVA tenderness. Extremities with good pulses and perfusion. An abdominal series and laboratory studies are ordered. He is given a dose of oral antacids.