6 Vaginal bleeding. All are correct. Lungs are clear on auscultation and percussion. Bowl sounds are absent and pain is easily elicited on palpation especially in the epigastric and right upper quadrant regions. The liver is tender but otherwise normal.
Rectal examination is normal, psoas and obturator signs are negative .
All are correct laparoscopic cholecystectomy is the treatment of choice. 3 Chest x-ray . 9 Abdominal and pelvic C.T. to exclude peritonitis 4. The gold standard for diagnosis is laparoscopy. In most cases, diagnosis of PID must be confirmed by laparoscopy.