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Pain starting around the navel, settling in the right lower abdomen — appendicitis; Alvarado high; appendectomy. Appendicitis (migratory — periumbilical → RIF: anorexia, nausea, McBurney's tenderness, fever; Alvarado score): uncomplicated — laparoscopic appendectomy; perforated — antibiotics + interval. Peritonitis (perforated ulcer — sudden severe pain, board-like rigidity, absent bowel sounds: resuscitate + broad antibiotics + laparotomy — Graham patch). Obstruction (colicky pain, vomiting, distension, absolute constipation: X-ray — air-fluid levels; NG tube + fluids; surgery if strangulation/peritonitis). The migrating pain is appendicitis — the rigid board is peritonitis.